final report - unicef• obtaining commitments and support of top leadership and policy makers for...
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IbftA do fM
UNICEF
FINAL REPORT
BY:
HOUSE OF CONSULTANTS LTD
52 New Eskatan Road, TMC Building, Dhaka-1000Tel: 8314452,8315570,8315305, Fax: 880-2-«311939, email; hcMpiangla.net
SUBMITTED TO:
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Project O^esr, WES: UNICES' Bas^adeslJ
Septen&er 26M
Acknowledgements are due for various roles assumed by thefollowing in our implementation of the study
/. For valuable guidance and sustained interest and ungrudging help andcomments throughout the tenure of the study from UNICEF:
AFROZA AHMED PHILIPPE BARRAGNE-BIGOTProject Officer Project OfficerW E S SECTION WES SECTIONUNICEF UNICEF
SHIRIN HUSSAIN SEHELI PARVEENProject Officer WES SectionIV ES SECTION' UNICEFUNICEF
DR. K. S. HUDA RAFIQUL HAIDERFormer Consultant Former ConsultantUNICEF UNICEF
I!. For valuable information, insight and future directions as to Social Mobilizationfrom DPHE:
MUHAMMAD QUAIDUZZAMAN ENGR. S.M.A. MUSLIMChief Engineer Additional Chief EngineerD P H E D P H EGovernment of Bangladesh Government of Bangladesh
DR. KAZ! AL! AZAMExecutive EngineerGOB-UNICEF PROJECTD P H E , Government of Bangladesh
///. For furnishing valuable information on several aspects of Social Mobilization(1937-99) and its further prospects and direction from NGO-Forum:
MR. M. A. RASHID MR. ENAMUL HUQ MONDALEXECUTIVE DIRECTOR PROGRAMME OFFICERNGO-Forum NGO-Forum
ABBREVIATIONS
ADP
BRAC
BRDB
DANIDA
DC
DCC
DPHE
FGD
H&FPO
HAPIC
ICDDRB
MOHFW
NGO
PRA
SAE
SMC
SocMob
UCC
UEO
UNO
UNDP
UNICEF
UP
VDP
uwcA&VDP
VSC
WATSAN
WHO
Annual Development Plan
Bangladesh Rural Advancement Committee
Bangladesh Rural Development Board
Danish International Development Assistance
Deputy Commissioner
District Coordination Committee
Department of Public Health Engineering
Focus Group Discussion
Health and Family Planning Officer
Hygiene Awareness and Product Information Campaign
International Center for Diarrhoeal Disease Research, Bangladesh
Ministry of Health and Family Welfare
Non Government Organization
Participatory Rural Appraisal
Sub-Assistant Engineer
School Management Committee
Social Mobilization
Upazila Coordination Committee
Upazila Education Officer
Upazila Nirbahi Officer
United Nations Development Programme
United Nations Children's Fund
Union Parishad
Village Defense Party
Union WATSAN Committee
Ansar and Village Defense Party
Village Sanitation Center
Water and Sanitation
World Health Organization
} TABLE OF CONTENTS
Page No.
I 1. INTRODUCTION AND BACKGROUND 1
- 1.1 Introduction 1; 1.2 Overview of Water Supply, Sanitation and Hygiene 1; 1.3 Background of Social Mobilization Programme 1
1.4 Objective of the Social Mobilization Programme, 1997-1999 2
I 2. OBJECTIVES SCOPE AND METHODOLOGY OF THE EVALUATION STUDY 3
! 2.1 Objectives of the Evaluation Project 3I 2.2 Scope of Work 3
2.2.1 The Coverage 3i 2.2.2 Programme Targets 3i 2.2.3 Individual Offices and Institutions involved in the Evaluation Study 5
2.3 METHODOLOGY 5<• 2.3.1 Survey Requirements 5l 2.3.2 Qualitative Survey 5
2.3.2.1 PRA/FGD 6-, 2.3.2.2 Case Studies 6j 2.3.3 Household Survey 6
2.4 Survey and Data Collection Methodology 62.4.1 Survey and Sample Design 7
2.5 Implementation Plan 8) 2.5.1 Preparation Phase 8( 2.5.1.1 Collection and Review of Records and Documents 8
2.5.1.2 Finalization of Checklists, Guidelines and Questionnaire 82.5.1.3 Training 8
i 3. LITERATURE REVIEW ON SOCMOB 11
i 3.1 Introduction 11i 3.2 Monitoring by BETS and OCTA 11
3.3 Completion Report of the SocMob by UNICEF, Bangladesh, 1999 12: 3.4 Report on Communication Material Pre-testing and Qualitative 13I Assessment of HAPIC\
4. FINDINGS OF THE STUDY 15I
3 4.1 Introduction 15
i 4.2 Advocacy Workshops at Different Levels . 15I 4.2.1 District 15
4.2.2 Upazila 164.2.3 Outcome of the Advocacy Workshops at the Dist. & Upazila Level 16
; 4.2.4 Union Level Advocacy Workshop 16; 4.2.5 Follow-up 16
•• 4.3 Training of Trainers 17
Page No.
4.4 Trainees as Trainers 174.4.1 Selection Criteria for Trainers 184.4.2 Outcome of Training 184.4.3 Recommendation 18
4.5 Motivational Activities 184.5.1 Status 184.5.2 Communication Materials 194.5.3 Subsides for Motivation 194.5.4 Recommendation 20
4.6 Opinion of DPHE, NGOs and Stakeholders on SocMob Activities 204.6.1 Department of Public Health Engineering (DPHE) 204.6.2 NGO Opinion 214.6.3 Stakeholders Opinion 234.6.4 Other Partners and Allies 23
4.7 Monitoring Activities 234.7.1 Monitoring by NGO-Forum 24
4.8 Construction of Latrines by NGOs 24
4.9 Coverage of Sanitary Latrines 244.9.1 Progotir Pathey Data 244.9.2 Household Survey 254.9.3 Focus Group Discussion 254.9.4 Findings From Case Studies of Users and Non-users 25
4.10 Net Effect of SocMob 26
5. ANALYSIS OF THE HOUSEHOLD SURVEY 27
5.1 Distribution of Household as to Household Head and Gender 275.2 Sanitary Latrines 275.3 Hand Washing 295.4 Use of Water 325.5 Witnessing SocMob Activities 325.6 Imams Participation in SocMob
6. LESSONS LEARNED FROM PARTNERS AND ALLIES 34
6.1 Introduction 346.2 Lesson Learned 34
Accomplishments:
6.2.1 Overall Change in Hygiene Awareness . 346.2.2 Partnership between DPHE/NGO or GOB-NGO 346.2.3 Sensitization and Coordination at District Level 346.2.4 Emphasis of Coordination at Upazila Level (Coop. Mech.) 356.2.5 Programme for Hygiene Awareness at the Union and Grassroots Level 356.2.6 Total Literacy Programme (TLM) 366.2.7 ' NGOs ~ 366.2.8 Private Sector 376.2.9 Poverty and use of Sanitary Latrine 376.2.10 Pockets of Ignorance 376.2.11 Continuity of Instruction of Hygiene Awareness 37
Obstacles:Page No.
6.3 Obstacles to Implementation of SocMob6.3.1 External Forces6.3.2 In-built Issues Needing Improvement
6.4 Recommendations and Future Directions
3737
,-•
APPENDICES
Appendix -1
Appendix - II
Appendix - III.A
Appendix — III.B
Appendix - III. C
Appendix - IV
Checklist for PRA
Questionnaires for Social Mobilization Programme(UNICEF) In-depth Interview Schedule
Participatory Rural Appraisal (PRA) in Kishoreganj District
PRA in Kushtia District
PRA with Sunamganj District
Case Study
1-2
1-5
1-20
1-16
1-25
EXECUTIVE SUMMARY
1. INTRODUCTIONThis study seeks to evaluate the performance of the Social Mobilization (SocMob) Programme onsanitation, hygiene and safe water use in its last phase, 1997-99.
From 1988 onwards, SocMob programme sought to create hygiene awareness to eliminate the healthhazards emanating from lack of sanitary latrines, drinking of unsafe water and absence of the practiceof hand washing. The programme was implemented by DPHE with assistance from UNICEF in threephases. The last phase was implemented between 1997-99.
The objectives of the 1997-99 phase of the SocMob Programme may be summed up as follows:
• Obtaining commitments and support of top leadership and policy makers for effectiveprogrammatic interventions at the grassroots; and
• Making alliance with different partners and allies like NGOs, school teachers, religiousleaders, elected representatives, local elites, local administration, medical professionals andworkers etc. to mobilize and motivate people at the grassroots to use sanitary latrines, adoptsafe personal hygiene practices and use safe water for all purposes.
2. PURPOSE AND SCOPE OF THE CURRENT EVALUATION STUDY
2.1 Purpose of the Evaluation Project
At the end of Phase-Ill of the programme in June 1999, UNICEF felt it necessary to evaluate itsimpacts and achievements. The lessons learnt in the process of evaluation will assist in forming theguidel ines of a larger project that UNICEF is going to undertake with the assistance of DFID.
2.2 Scope of Work
The ToR specifies that qualitative assessment is to be undertaken:
• To determine if the outcome has been fu l f i l led .• To identify problems encountered• To specify lessons learnt that could be appl ied in the future programme
The above tasks w i l l be examined in the context of:
Advocacy workshops at different levels;Training of trainers, partners and allies;Motivational activities at the grassroots;Opinion of stakeholders on SocMob activities;Monitoring of activities;Construction of latrine by NGOs; andLessons learnt from partners and allies.
3. METHODOLOGY OF THE STUDY
The time allowed for the evaluation of the programme is 3 months. The programme covers 32districts of the country. With due consultation with the UNICEF, the methodology for the evaluationstudy was decided. The methodology includes:
• Relevant literature review• Focus Group Discussion at different levels (District, Upazila, Union, Village level). In
consultation with the UNICEF, more emphasis was put on Focus Group Discussion;« Intensive interviews with D.Cs, UNOs, Senior DPHE and NGO-Forurn Officials;• A household survey with a semi-structured questionnaire;• Several case studies.
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4. FINDINGS
The Process of Implementation
4.1 Advocacy Workshops
The advocacy workshops were held at district, upazila and u n i o n levels. Government officials thereexpressed their solidarity with the programme. However, the work plan designed in the advocacy-workshops was not ful ly followed or pursued. The follow-up required coordination at district, upazilaand u n i o n levels.
4.2 Training Programme
The t ra in ing programmes appear to have been implemented satisfactorily, specially through theintervention of the NGO-Forum and other partner NGOs. Training was participatory and the deliveryand diction of the trainers were clear. SAE (DPHE) could participate as trainers at the un ion levelbesides the trainers trained by NGOs.
4.3 Motivational Activities at the Grassroots
PRA/FGD, intensive interviews and household surveys indicate that people at the grassroots levelwere exposed to this or that motivational activity or activities. Some heard miking, others saw TVprogramme or listened to radios or participated in WATSAN fair or "Uthan Baithaks" or saw posters,leaflets and the l ike . Women in the villages were approached by health and family p l a n n i n g workers.Intervention of the Imams before "Khutba" or the Friday prayer is also reported. Thus, anoverwhelming majority of the people got exposed to SocMob ideas on sanitation and hygienethrough one or more motivational activities. And yet further strides in these l ines w i l l be necessary toattain effective social mobilization.
It is now evident that simple knowledge and awareness are not enough to induce one to ins ta l l asanitary latrine or wash hands with soap after defecation. These are behavioural issues and wouldrequire more sustained effort on the part of the social organization, which desire to bring aboutchanges in behavior pattern. A critical level of awareness has to be reached. And for this purpose,continuous social mobilization for hygiene awareness is necessary. The ideas of SocMob have to beinstilled in the minds of the people. A high powered salesmanship is necessary. Motivationalactivities at the grassroots did not reach that level or that peak.
Communication:
Our PRA at the sanitary latrine user and non-user level shows that most people l iked the outdoormedia like hoarding, stickers, posters, wall paintings etc. The HAPIC study, which did more incisivework on communication materials, also found that most people l iked the communication materials.Shopkeepers and individual households like to display the posters or sandwich boards. Future projectintervention would fall upon the findings of the HAPIC study. It has to be noted that in a continuousprogramme, a poster or dramatic intervention tends to lose its appeal and lustre after a certain span oft ime. New items have to be routinely introduced. There is scope for research and study in this area.DPHE and some stakeholders thought that there was room for improvement in this area.
Subsidies and Motivation
In development scenarios, subsidies have often played a vital role. With almost half the people belowthe poverty line, purchase of sanitary latrines may appear difficult . Outright dole of sanitary latrinesis advocated by some poorer people. It is sometimes claimed that if prices are halved, 95 per cent ofthe people wi l l install sanitary latrines. However, the prospect of subsidizing sanitary latrines has notfound favour with the policy makers or responsible organizations involved with SocMob.
It has also been suggested by some NGOs or stakeholders that VGD programme of GOB or loanprogramme of the NGOs may be tied up with installation of such latrines. It may be mentioned in thisconnection that prices are sought to be kept low at a range of Tk. 300.00 through NGO interventionand distribution under this supply-pushed sales programme. There is now suggestion for even ademand-pulled marketing of sanitary latrines.
4.4 Opinion of Stakeholders and Allies on SocMob Activities
There are stakeholders at district, upazila and union levels.
District: At the district level, government officials expressed their appreciation of SocMob, andwished to participate and render assistance to the programme.
The D.Cs in the FGD districts were too busy and could not participate in the FGD. The CivilSurgeon, DEO, Deputy Director, Islamic Foundation and District Information Officer claimed to haveassisted SocMob. Their assistance could be better streamlined with a district coordinating/facilitatingagency for SocMob.
Upazila: Upazila level officials appreciated the objectives of SocMob and rendered services invarying degrees. Lack of coordination is also felt at this stage. NGOs and SAE/DPHE suggested thatUNO take-up coordination at the Upazila level. Lack of manpower in the office of the SAE/DPHE forassisting coordination was often mentioned at the Upazila level.
Union: The UP Chairmen were not uniformly motivated. Where UP Chairman got motivated,SocMob activities worked better. The example of the initiative taken by the chairman of theKengragesi Union of Kolaroa Upazila may be seen under Section 4.6.1. The UP chairman mobilizedthe parents and guardians of children defecating in open places to install pit latrines. UNOs maymotivate the UP Chairmen/Members. UP level H&FP workers, AVDP members, school teachers andstudents showed eagerness to participate in social mobilization. However, after training, the schoolteachers and students often found no role due to the absence of a coordinating agency at the UP level.
In sum, the stakeholders opined for more continuous programme and coordinated efforts.Their commitment remains and could be further reinforced in the future.
NGO-Ojpinion: NGO-Forum along with other partner NGOs found SocMob necessary. Theyhad the ability to monitor the programme. They think the motivational work fell somewhat short ofstipulation. NGO-Forum found the WATSAN Committees non-functional in many Upazilas. NGOsthought that SocMob programme, with the dislocation of 1998 floods, did not have enough time toyield stipulated results. They opined that SocMob reached the people but fell short of a mobilization.NGOs at the Upazila level wished the UNO to co-ordinate SocMob activity and sit with the relevantUpazila level staff and NGOs for coordination of efforts.
4.5 Monitoring of Activities
Monitoring of SocMob activities needs to be further strengthened. Without a coordinating or overallfacilitating agency, monitoring could not pick up. However, NGO-Forum or major NGOs maintainedthat they have well-established monitoring apparatus.
4.5.1 Construction of Latrine by NGOs
The NGOs planned to construct more'than 3 lac latrines. Latest report said that NGOs have fulfilled98 per cent of their target.
Overall coverage of sanitary latrines in the rural areas of the 32 districts will be around 40 per cent.The NGOs could not give any such figure in the absence of surveys. FGD in rural areas indicatedcoverage from 40 per cent to less than 50 per cent. The household survey shows that 49 per cent ofthe households under survey have sanitary latrines. The survey figures are for January 2000.
5. HOUSEHOLD SURVEY
The household survey yielded information on ownership of sanitary latrine, hand washing, use of safewater and witnessing of SocMob activities. 48% of the respondents said that children belonging to 3-5 year age group defecated in open space while only 28% reported using latrines. About two-thirdsreported ownership of some kind of latrine. All people having a monthly income of Tk. 5000 hadsanitary latrine.
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Half the people having sanitary latrine reported that they had these in the course of the last 3 years.Only less than one-third of the respondents acknowledged receipt of assistance for installing sanitarylatrines.
87 per cent of the respondents heard of the need for hand washing. Here also, half of the 87per centrespondents heard about it in the last 3 years. Hand washing with soap remains at 35 per cent, belowSocMob target of 40 per cent.
75 per cent of respondents reported witnessing SocMob activities.
6. LESSONS LEARNT FROM PARTNERS ANB ALLIES
6.1 Accomplishments
(a) Increase In Hygiene Awareness: Social mobilization programme for sanitation,hygiene and safe water use has succeeded in creating some measure of hygieneawareness among a large section of people of the 32 intervention districts thoughaccomplishment has fallen short of targets and expectation of outright socialmobilization. Further efforts are necessary to reach anywhere near to socialmobilization.
(b) Productive GO-NGO Partnership: Partnership between GO-NGO has emergedat the local government level while implementing SocMob which augers well forrural development activities in the country. NGOs together with other Upazila levelgovernment officials seek coordination of SocMob activities at Upazila level underthe leadership of UNO.
(c) UP Chairman's Role: The role of the UP Chairman in social mobilization at thegrassroots has been appreciated in areas where they have come forward for SocMob.
(d) NGOs Role: NGOs have shown their management and social intervention abilitiesin the course of SocMob. They can be relied upon with future social development.They have distributed sanitary latrines efficiently.
(e) Grassroots GOB Workers: The capability of grassroots level governmentofficials from H&FP department, school teachers and students, Imams and A&VDPmembers has been demonstrated, in connection with SocMob. Their work needsmore guidance, coordination and monitoring.
(f) Private Sector Producers: They are marketing sanitary latrines. Theirparticipation will further increase as demand-pull marketing environment gets wellestablished.
(g) Capability of SocMob Programme: Its capability has been established over 1997-99. Valuable allies have been made among district, upazila and union level officials,elite, school teachers etc. A future programme in this line could fall upon this base.The base may be further expanded through inclusion of political and social leaders,youth and women groups/clubs, high school teachers and students and the like.
6.2 Obstacles
And yet there are some obstacles to the expeditious expansion of SocMob hygieneawareness.
(a) Behavioural Changes: It has to be admitted that SocMob is concerned withbehavioural changes in as much as it seeks to develop the habit of using sanitarylatrines in stead of open defecation or hanging latrines. Behavioural changes maytake time and no quick remedies could be postulated here. Planners, projectformulators and target setters will have to bear this phenomenon in mind. Otherwise,one falls into the trap of the fallacy of easy solutions.
(b) Benchmark Survey: Should have been there to facilitate programme evaluation.(c) Absence of a Central Coordinating/Facilitating Agency: Absence of such an
agency with branches at Upazila levels worked as an obstacle to smooth functioningof SocMob.
(d) Centralized Monitoring: Relative absence of Centralized Monitoring withappropriate branches down the tiers of local government also served as an obstacle.
(e) 'Grassroots Level Activities Needed More Attention: More emphasis shouldhave been placed on grassroots level organization, advocacy, motivation, persuasionand coordination. Beneficiaries stay there in the far-flung villages.
(f) Technical Knowledge of the Sanitary Latrine: Such knowledge shall have tobe carried to the grassroots level. Training may be given to the village elite or unioncouncil member or A&VDP who should be helping the common man in the village.This technical knowledge pertains to the gooseneck, quality of the rings and slabs,(wall and cover of the latrines) or the flood depth of the place of installation ofsanitary latrines.
(g) Inter-Departmental Co-operation: There have been occasions whenmisunderstanding ensued as invitation to workshops/meetings originated from onegovernment office (SAE/DPHE) to government officials from other services.Leadership of DPHE has to be established in this matter.
(h) Motivational Work at UP Level Needed Further Improvement: WhileNGOs worked successfully, some UP Chairmen and Members felt lukewarm toSocMob, considering this to be a mere NGO venture. Fu l l participation of UPChairmen/Members could not be ensured.
(i) Position of DPHE: A somewhat more active role of DPHE with respect toSocMob 1997-99 would have helped the programme.
(j) Poverty: A distinct obstacle to the SocMob programme appears to be the poverty ofthe beneficiaries.
(k) 1998 Flood: An emphimerel but substantive obstacle to the implementation ofSocMob was due to the unforeseen floods of 1998 when local government officialsgot entrenched in flood relief and rehabilitation. The work plan and results ofadvocacy workshops got sidestepped. This, of course, is not a fault of programmedesign.
(1) The Time Span of 1997-99 programme: This time span is considered somewhatl imited compared to the tasks/targets according to many NGOs who worked at thegrassroots level.
7. RECOMMENDATIONS AND FUTURE DIRECTIONS
DISTRICT LEVEL1. District Advocacy Workshops: District level advocacy workshops and training may now
be held putting emphasis on district level planning, coordination and monitoring.2a. District Facilitating Agency: A facilitating agency should be earmrked at the district level
to monitor hygiene awareness building activities and pursue the district level officers whohave their departmental activities. Executive Engineer, DPHE, should take the leadership inthis connection. He, in alliance with suitably selected NGOs, could offer the base for thisfacilitating agency.
2.b District Co-ordinating Agency: The District Co-ordination Committee (DCC) will heentrusted with the task of co-ordination of the efforts of the district level governmentofficers.
3. Pursuing District Officials: District level officials have support for hygiene awarenessprogramme but they have to be pursued to come forward with their assistance andmanpower. Executive Engineer, DPHE should do this job of pursuing
4. Training for Sanitary Latrines: Advocacy and knowledge about sanitary latrines nowshould be taken to the union and village or 'Uthan Baithak' level. Hence, district level-training may yield to upazila/union level training arrangements.
UPAZILA LEVEL
5a. Coordination at Upazila: Upazila may be the real focus of attention and Upazila Co-ordination Committee (UCC) should do the act of co-ordination of the Upazila levelgovernment officers and NGOs in connection with SocMob.
5b. Facilitating Agency: SAE/DPHE should act as the head of the facilitating agency. He maybe helped in this connection by suitably selected NGOs as SAE/DPHE does not have enoughmanpower at his disposal to do these works.
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6. Monitoring at Upazila: Monitoring should be coordinated at the Upazila level withvarious government agencies working at the Upazila level. The facilitating agency headed bySAE/DPHE will undertake monitoring assisted by NGOs selected for the purpose;
5. Training for hygiene awareness will preferably be planned at Upazila level with liaison withunion parishads
UNION LEVEL
6. Union Level Partners: Union Parishad Chairmen/Members should be the focus ofoperation and perform the act of co-ordination. Suitable NGOs selected by the SocMobProject could assist as a facilitation agency along with volunteering school teachers andyouth groups. The coordinating apparatus at the union level should rope in, among others,the services of the following government personnel/offices working at the union/village level.The following are;
•:• Health and Family Planning workers stationed at satellite clinics, FWC/EPI centers,etc.;
•> Village primary school teachers/students/•:• Imam of mosques•'• Ansar and VDP.
7. Union Level Allies: Besides the above, NGO workers, private producers, UP members,youth club members, high school teachers and students may also be invited to participate inhygiene awareness building.
Village and Household
10. Village Level Motivation:
• While motivational activities in the form of miking and postering may still continue, theemphasis now should preferably be laid on entering into a dialogue with the villagers onchanges in behaviour and subsequent acceptance of the improved hygienic practices.These dialogues could be held in village schools and courtyard meetings. Femalemembers of the Union Parishads may be encouraged and implored to contact andaddress the women in the villages. The above organizations and personnel listed underthe union level operation should be detailed to go to the villages, specially those who arefrequent visitors or residents of the relevant village.
• Permanent village level hygiene outfit: To make hygiene awareness a continuous processin the foreseeable future, a permanent arrangement may be made at the village level inthe form of a society that will continue with occasional meetings and monitoring ofvillage level changes in hygienic practice in general and sanitary latrine in particular.
General RecommendationsSome general recommendations are offered below. There could be some overlap with local levelrecommendations, but logical development of the recommendations may require this.
11. Continuity: Hygiene awareness building should be made a continuous process to motivatenon-users of sanitary latrines and non-acceptors of hand washing and other importanthygienic practices. The focus of attention should be the union, the rural schools, villagesand other grassroots level people and institutions including the Imam, Teachers,Ansar/VDP personnel and field level Health and Family Planning workers.
12. Coordination: There is a need for co-ordination of the SocMob activities at various levels.The DCC and UCC should be doing this co-ordination at the district and upazila levelsrespectively. Executive Engineer/DPHE and SAE/DPHE will take the leadership of theSocMob activities and suitably selected NGOs may be placed with them to renderassistance in this respect in view of their manpower limitations. Cost of NGO services maybe included in project cost.
13a. NGO opinion on upazila level co-ordination: While appreciating the possible role ofSAE/DPHE and UCC, the NGOs maintain that Upazila Nirbahi Officer (UNO) has aspecial role to play in SoMob and hygiene awareness. This is so because the hygiene
awareness activities will have to be taken to the villages through the Union Parishads andthe UNOs have a special clout on the UP Chairmen/members.
13b. Other NGO Opinions on Co-ordination: NGOs have worked in the last phase of SocMoband therefore their experience and opinions are -worth-noting.
» Education offices at the district and Upazila level should write letters to theschools asking them to participate in the programme;
» The Civil Surgeon of the district and Upazila Health and Family Planning Officershould be more involved in the programme;
» Family Planning, A&VDP officials should be coordinated in the work through theUNO and DP HE.
14. Training: Training for hygiene awareness now should be held at the level of UnionParishad, Village and other grassroots. Awareness building and motivation based ondialogue at the village level should be the principal theme of training. Besides these,training may be imparted on the structure of the latrine, the roofs and levels of rings etc.PEA showed that people cared to know about these aspects of the sanitary latrines.Information on children 's defecation and subsequent hand-washing may be stressed inthese trainings.
i15. Motivations: Motivation shall remain the main instrument of SocMob. Motivational
j activity should now be aimed at house to house canvassing for installation of sanitaryI latrine at differing costs reflecting differing options for rings and slabs. The good work of
posters, leaflets, folksong and fairs including radio and television programmes shouldcontinue. However, stress may be laid on courtyard meetings.
I 16. NGO Loans Tied-up with Sanitary Latrines: It is also recommended that NGO orGrameen Bank loans or VGD assistance of GOB may be tied-up with the installation of
-] sanitary latrines.1 17. Monitoring: St?-ong monitoring should constitute an integral part of any future programme
of social mobilization. DPHE should undertake the monitoring of the SocMob related} activities, extending from the center to the Union Parishad level through the upazilas, and\ the districts.
. 18. Funds for the Grassroots: Experience with the last phase of the SocMob will support theI view for enhanced provision of funds for grassroots SocMob activities.
19. Benchmark Survey: In future projects of this nature, it will be advisable to have a3 benchmark survey on knowledge, attitude and practice so that monitoring and evaluation\ may be facilitated.j
20. NGO's Role: NGOs are in the field installing sanitary latrines even without the} participation of the DPHE/UNICEF. Their work in the field should be appreciated and the
_J scope of joint DPHE/NGO monitoring and evaluation may be explored. Association ofNGOs with the implementation of SocMob project run by DPHE will fruitful as NGOs haveexperience in this motivational work at the grassroots level. NGOs have a great outreach
\ upto village level and good interpersonal skill.
21. Specific Role for Schools/Students: School teachers and students showed considerableinterest in the SocMob, but there was not time to harness their interest for SocMob
j programme. Their enthusiasm for the programme may be meaningfully utilized._}22. Partnership with TLM and NFE: Total Literacy Movement (TLM) and Non-formal
Education (NFE) may be associated with awareness building as to health and sanitation as\ these programmes are associated with grassroots level actions.
23. Research: A research and development programme should be initiated, taking into, consideration the.social, psychological, communication and interpersonal skill aspect of\ awareness building and motivation creation. Further, research on environmental impact of
pit latrines may also be initiated.
CHAPTER 1
INTRODUCTION AND BACKGROUND
HAPTER -1: INTRODUCTION AND BACKGROUND
1.1 Introduction
This is a study relating to the evaluation of Social Mobilization Programme (SocMob) for sanitation,hygiene and safe water use. This study has been undertaken by the House of Consultants Ltd. (HCL)under a contract with UNICEF, Bangladesh. HCL appointed Dr. Mahfuzul Huq (Team Leader), Mr.Mahiuddin Ahmed, Dr. Dilruba Ahmed, Mr. Manzurul A lam, at al for the evaluation study, whichspread over a period of 12 weeks around the beginning of 2000 A.D.
Afroza Ahmed, Project Officer, WES Section, UNICEF, Dhaka served as a contact person andoffered valuable guidelines in the implementation of the study.
1.2 Overview of Water Supply, Sanitation and Hygiene
Infant mortality in Bangladesh is quite high. The average annual incidence of diarrhea amongchildren under five is 3-5 episode, resulting in severe malnutrit ion and sometimes deaths.
For a long time before independence in 1971, outbreak of cholera in an epidemic form,diarrohea andother water borne diseases were common and took a heavy toll of life of both adults and children. Useof contaminated surface water was commonly held responsible for this. Therefore, supply of safewater through tubewells was considered a prerequisite for reducing the incidence of such disease anddeath.
It has been felt earlier that drinking safe water is a necessary but not a sufficient condition to inducesignificant decline in under five mortality and morbidity caused bydiarrheal diseases. Use of safewater for all purposes, inc luding household uses and washing, improvement of environment throughsanitary disposal of human excreta, and adoption of safe hygiene practices are other essentialprerequisites.
The importance of sanitary latrines has been appreciated and access to sanitary latrines has increasedfrom only 1 percent in 1971 to about 37 percent in 1998 amidst considerable variations amongdistricts. The trend in sanitary latrine coverage has stagnated between 30 and 40 percent since 1993.The percentage of population using hanging latrine or resorting to open defecation is s t i l l high andshowed no sign of mitigation. ^
Prevalence of safe personal hygiene among people st i l l needs much to be improved. A study hasshown that less than 50 percent of the population used rubbing agent (such as ash or soil) for washinghands after defecation. Use of such agent is very limited. Only 6 percent of the population in ruralareas and 9 percent at the national level wash their hands with soap after defecation. Only 3 percent ofthe population wash hands before meal.2
1.3 Background of Social Mobilization Programme
DPHE has been playing a pioneering role in promoting sanitation from the pre-independence days.Promotion of sanitation in Bangladesh (East Pakistan) started as early as 1962. It started providingsanitary latrine sets free of cost. But it could not make much headway for lack of proper knowledge,hygiene awareness and attitude. Social mobilization programme sought to build this hygieneawareness.
In the process of implementation of the water supply, sanitation and hygiene programmes, it has beenrealized that changing people's attitude and consequent behavioral development is very critical. Suchchanges in attitude and behavioral development require sustained intensive social mobilization andmotivation campaign. Thus, the social mobilization programme started from 1988 and wasimplemented in 3 phases i.e. 1988-1992, 1993-1996 and 1997-1999.
1 BBS, UNICEF, Progotiar Pothey (Dhaka, Ministry of Planning, 1990-1998)2 UNICEF, Bangladesh-Completion Report of the Social Mobilization Programme, 1999
\\PC1\PC1_E\Report-fiUNICEF-SocMob\FinalRepoftCtiapter-1 1
1.4 Objective of the Social Mobilization Programme, 1997 - 1999
The following were the objectives of the Social Mobilization Programme
: * To make people aware of the disastrous impact of poor environmental sanitation, non> adoption of safe personal hygiene practices, and use of contaminated water for dr inking and
other domestic purposes on their family health and survival.
: « To sensitize top leadership and policy makers to the problems of poor sanitation and hygieneto obtain necessary political commitments and support for effective programmaticinterventions.
« To make alliance with different partners and al l ies l ikeNGOs, school children, religiousleaders, elected representatives, local elite, local administration, medical professionals andworkers, etc. to initiate massive social mobilization activities and campaigns to promote safewater use, better hygiene practices and environmental sanitation.
« To sensitize and motivate people with the help of allies and partners to use safe water for allpurpose, adopt safe personal hygiene practices, and construct, use and maintain sanitarylatrines.
« To use various communication channels l ike radio, television, folk media, popular theatre,and interpersonal channels to sensitize and motivate people at the grass roots.
\\PC1\PC1 HReDorf-ftUW/CEF-SocMoMfina! ReDortOanteM
CHAPTER 2
OBJECTIVES SCOPE AND METHODOLOGYOF THE EVALUAITON STUDY
U
HAPTER - 2: OBJECTIVES, SCOPE AND METHODOLOGY OF THEEVALUATION STUDY
2.1 Objectives of the Evaluation Project
The last phase (1997-99) of the SocMob programme, which started functioning in 1993, came to anend in June 1999. At the end of the programme UNICEF felt it necessary to evaluate the impacts andachievements, determine if the outcome has fulf i l led the expectations, identify the problemsencountered and specify the lessons learnt. The lessons learnt w i l l assist in forming the guidel ines of alarger project that UNICEF is going to undertake with the assistance of DFID.
2.2 Scope of Work
The TOR specifies that qualitative assessment is to be undertaken:
» To determine if the outcome has been fu l f i l l ed .* To identify problems encountered• To specify lessons learnt that could be applied in the future programme
2.2.1 The Coverage
The programme was undertaken in 32 out of the 64 districts (Figure - 2.1). The decision to l imitprogrammatic intervention only in 32 districts was made in view of the fact that funds available wasinadequate and spreading it th in ly over all the districts would be unproductive. The selection of thedistricts was made on the basis of two specific criteria-low coverage in sanitary latrine and poorpersonal hygiene practices (greater weight, however, was given to latrine coverage). Two exceptions,however, were made. Rajshahi and Nawabgonj districts were included although both the districts havesanitary latrine coverage above the national average. Such exception was made primarily becauseUNICEF earlier facilitated the 100 per cent sanitation coverage programme in those two districts withthe participation of district and than a level government officials, private producers and NGOs.
2.2.2 Programme Targets
The expectation of the SocMob programme was to achieve the following targets: '1997-1999
• Increase sanitary latrine coverage - From < 39% to 50%• Increase the practice of hand washing with water and soap - From < 34% to 40%• Reduce use of pond water for domestic purpose - From <43% to 25%
According to the programme target, the activities given at the top ofTable 2.1 were performed. Inorder to evaluate the programme, the status and outcome of the following broad tasks are to beperformed.
/ UNICEF. Bangladesh: (i) Completion Report of the Social Mobilization Programme, Page 9-10(ii) Social Mobilization Programme. Implementation Plan, Page - 2
* NGOs also made commitment to install a total number of 2,75,000 latrines, ibid, Page - 10
UPC HPC LBReport-AlMCEF-SocMoMBna/ Reoort\OiaBfer-2.doc
Figure : 2.1Jtl 9f-0ff S8--00
-1
*f M 1-f M
Insert Figure
BPC 1\PC1_BRapari-MNICEF-SocMob\Final Report\Cftaofer-2.doc
; • Advocacy workshops at different levels;I » Training of trainers;
• Training of partners and allies;• Motivationalactivities at the grassroots;
| • Opinion of stakeholders on SocMob activities;i • Monitoring of activities;
» Construction of latrine by NGOs;} • Lessons learnt from partners and all ies.i
2.2.3 Individual Offices and Institutions involved in the Evaluation Study
j In the implementation of the evaluation study, government officials, elite and NGOs at district,thana! and u n i o n levels were interviewed in their role as partners and a l l i e s .
j 2.3 METHODOLOGY
2.3.1 Survey Requirements>I The evaluat ion of a project involves the assessment of impacts and achievements of the outputs
expected. But social mobilization process is gradually transmitted from the or igin to the beneficiariesfol lowing a r ipp l ing characteristic. The programme thus initiated in 1997 may not have made
_ _ j substantial impact as yet on the beneficiaries who are the ult imate target of the programme. In view of3 the above, the ToR has specified for qualitative assessment which was followed.
j 2.3.2 Qualitative Surveyjj
Various methods are followed in qualitative survey. These inc lude:
I • PRA/FGD;J • Case study;
• In-depth Interview;1 • Household survey
2.3.2.1 PRA/FGD
I PRA includes various analyses, which include time trend analysis, perception stories, focus groupdiscussion etc. In this evaluation, Focus Group Discussion (FGD) was an effective tool and hasrightly been mentioned in the ToR.
! In addition, the FGD was conducted by to the Team Leader and the Sociologist, six FGD teams, eachconsisting of a Facilitator and a Rapporteur. One of the members of each FGD team was a female.The female member of the FGD team did moderation of the FGD with female participants.
iA set of checklists, prepared for FGD with each type of respondents after thorough discussion withUNICEF, were pre-tested and modified. A draft copy of the FGD checklist is given at (Appendix 1).
- - i The Facilitator was responsible for selecting participants, arranging accommodation, and maintainingliaison and co-ordination. Notes were taken down by the Rapporteur and simultaneously recorded ona tape recorder. The notes of Rapporteur were verified with the tape recording at the end of each
; FGD. Standard principles and procedures in conducing FGD were strictly followed.
Findings of FGD in Kishoreganj, ICushtia and Sunamganj are offered in Appendix-3A, 3B and 3Ci respectively.
This is apparent that the programme involved district headquarters, thana headquarters and unions.Though these cannot be distinctly classified as there is a lot of overlap and involvement of personsfrom different levels, yet we can classify them activity-wise in three groups. This classificationconsiders the location of persons concerned:
jJ \\PC1\PC1 BReoort-MlNlCEF-SocMolifinalRemrbChaoter-ldac <
f • District level activities;J • Thana level activities;
• Union/Village level activitiesii District level activities include:
• District level advocacy workshop;' • TOT for the district training network.i
Similarly, the following three figure strongly in thana centre programme:!
1 • Thana advocacy workshop;• Workshop of Health and Family Planning Officials;• Training of private producers.
> The remaining (listed below) programmes have strong base at the village and un ion levels:
j • Training of Ansar/VDP members;j • Training of volunteer sanitation karmi (workers);
• Training of UP Members;, . WATSAN fair;
-~i • Video film show;' • Folk cultural show;
• WATSAN committee meeting;• Mik ing through WATSAN committee;
j • Rally through WATSAN committee;• Imam training
1 The activities of SocMob may be seen from Table 2.1 at the end of this chapter.
2.3.2.2 Case StudiesI' I n d i v i d u a l (appropriate) cases were studied to bring out the process followed, bottlenecks faced and
means of surmounting them. This exercise explored, on the one hand, the users' perception and on theother hand the influence of the programmes.
i2.3.2.3 In Depth Interview
I The in-depth interviews were also conducted by six teams in the six districts of six divisions. Each5 team consisted of a male-female interviewer. For the in-depth interviews the respondents were
selected ensuring that all programmes are covered. Respondents selected for the in-depth interviewsj were different from the participants in the FGDs.
2.3.3 Household Survey
A semi-structured questionnaire was developed in consultation with UNICEF and DPHE for thehousehold survey. The questionnaire was pre-tested and finalized prior to conducting the actualinterviews. The draft questionnaire used for the in-depth interviews is at Appendix-2. This wascarefully finalized in cooperation with UNICEF. More emphasis was placed on FGD/PRA thanhousehold survey as per the joint decision of UNICEF and HCL, as reported in the Inception Report.
2.4 Survey and Data Collection
The study involves evaluation of implementation, training, campaign etc. This involved review of allmaterials available.
\\PC1\PC1_E\Report-WNICEF-SocMob\FinalReDOftCtiaoter-2.doc
In implementation, NGO Forum for drinking water supply and sanitation occupies the focal point.They arrange and co-ordinate the meetings at the district level, facilitate thana level activities, followup and monitor the activities under the programme at different levels.
The modules of training used in different trainings were collected. BRAC provided the trainingmaterials during training.
Campaign materials, audio-visual materials or WATSAN theme stickers, scripts, booklets, manuals,flip charts were collected and reviewed by the Media and Communication Specialist.
2.4.1 Survey and Sample Design
The study design was prepared in keeping with the time available for the project. Naturally, the studywas undertaken on sample basis. In drawing the samples, interventions made at different levels havebeen taken into consideration.
One district from each of the six divisions has been selected in such a manner that all types ofinterventions made by the project are covered by the sample districts. In consideration of the above,the final selection of districts was made in consultation with the UNICEF consultants and the ProjectCoordinator.
Table 2.2Sampled Districts, Upazilas and Unions
Chhatak Jowerabazar
Sunamganj Saidergaon
Sunamganj LakshanshreeJoykalas
Atghoria Chandva
Pabna Majhpara
Eswardi • PakseyDasuria
Patuakhali Badarpur
Patuakhali Kalikapur
Bauphal DasparaKalaiya
Bheramara Bahirchar
Kushtia Dharampur
Mirpur AmlaBaruipara
MymensinghMuktagachha Ghoga
Kashimpur
Trishal SakhuaBoilder
KishoreganjKishoreganj Jasodal
RashidabadPakundia Hossaindi
Chandipasha
The selection of upazilas within the selected districts and unions within the selected upalizas wasmade from- the lists contained in the activity report prepared by UNICEF, Table 2.2 presents thename of selected districts, upazilas and unions.
; Two upazilas from each of the six districts were selected at random as all the upalizas of thei programme districts have been covered. Two randomly selected un ions of each thana were covered.
FGD was conducted at the upazila and union levels. The selected upalizas and unions were reviewed:. by UNICEF and DPHE.
2.5 Implementation Plan
i Implementation plan describes activities that were performed and their schedule and sequences. The• work plan has been divided into several phases:
j • Preparation phase;] • Data collection;
• Report preparation;i • Presentation and finalization.I1 2.5.1 Preparation Phase
j 2.5.1.1 Collection and Review of Records and Documents*
• Reports of previous studies in the relevant field were collected and reviewed. Sources:_] UNICEF, DPHE, ICDDRB, Research organizations;
j • Monitoring reports of social mobilization progress, sources, Sources: UNICEF, ExecutiveEngineer of DPHE, DPHE Project Office, NGO Forum and parter NGOs;
] • Training materials, training modules of t ra ining conducted by BRAC, DPHE, etc.] • Reports and workshop outcomes of various advocacy programmes;
• Campaign materials: posters, fliers, flip charts, design of boarding etc. Source: UNICEF,< DPHE, Interspeed Advertising Agency;i • Radio and TV campaign materials, source: UNICEF, DPHE;
• Training materials for Imam training;1 • Text of plays and dramas;j • Text of miking and schedules; ,
• Schedule of rallies;i • Participation at fairs;I • Folksong texts and lyrics.
, 2.5.1.2 Finalization of Checklists, Guidelines and QuestionnairesIJ Draft checklist and questionnaire were modified in consultation with UNICEF. Guidelines to be
followed by facilitators and interviewers were prepared. The Bengali version of questionnaire wasi printed in sufficient numbers.I
2.5.1.3 Training
\ Training was conducted as described above.
The PRA (FGD) facilitators to work on the project have already been mentioned and 18 interviewers' were subsequently selected from the roaster of socio-economic surveyors who regularly work withj HCL. Half of the interviewers were female.
; Field tests were carried out in a programme area location near Dhaka to find the adequacy of the] checklist and appropriateness of the questionnaire.
«PC(\PC( RRmnrt./y Mr.£F-Snr-Mnh\Kn:
Table 2.1 : Types of Intervention in Various Districts
Name ofDistrict
Bandarban
Noakhali
Gopalgonj
Jamalpur
Kishorgonj
Madaripur
Tlymensingh
Netrokona
Rajbari
Sariatpur
Sherpur
Tangail
Jhenaida
Kushtia
Satkhira
Dinajpur
Gaibandha
Joypurhat
Kurigram
DistrictAdvocacyWorkshop
1 .
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
ThanaAdvocacyWorkshop
7
6
5
7
13
4
12
10
4
6
5
11
6
6
7
13
7
5
9
IOI for theDistrict
TrainingNetwork
1
1
Workshop ofHealth andFP Officials
3
2
2
Training ofAnsar/
VDPMembers
Training ofVolunteerSanitation
Karmi
38
Trainingof UP
Members
21
Training of•Private
Producers
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
WATSAN Fair
7
6
5
7
13
4
12
10
4
6
5
11
6
6
7
13
7
5
9
VideoFilm
show
29
82
69
68
106
58
146
85
42
61
52
103
68
61
77
102
82
31
74
FolkCultural
Show
7
6
5
7
13
4
12
10
4
6
5
11
6
6
7
13
7
5
9
WATSANCommittee
Meeting
145
410
345
340
530
290
730
425
.210
305
260
515
340
305
385
510
410
155
370
Mikingthrough
WATSANCommittee
145
410
345
340
530
290
730
425
210
305
260
515
340
305
385
510
410
155
370
Rallythrough
WATSANCommittee
29
82
69
68
106
58
146
85
42
61
52
103
68
61
77
102
82
31
74
ImamTraining
Table 2.1 : Types of Intervention in Various Districts
3I. No.
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
Name ofDistrict
Naogaon
Nawabgonj
Nikphamari
Pabna
Panchagarh
Rajshahi
Rangpur
Thakurgaon
Barguna
Bhula
Patuakhali
Habigonj
Sunamgonj
Comilla
Faridpur
Jessore
MoulviBazar
TOTAL =
DistrictAdvocacyWorkshop
1
1
1
1
1
1
1
1
1
1
1
1
1
32
ThanaAdvocacyWorkshop
11
5
6
9
5
9
8
5
5
7
6
8
10
237
IOI for theDistrict
TrainingNetwork
2
2
1
1
1
1
10
Workshop ofHealth andFP Officials
2
3
12
Training ofAnsar/
VDPMembers
6
10
16
Training ofVolunteerSanitation
Karmi
38
Trainingof UP
Members
21
Training ofPrivate
Producers
1
1
1
1
1
1
1
1
1
1
1
1
1
32
WATSAN Fair
11
5
6
9
5
9
8
5
5
7
6
8
10
237
VideoFilm
show
99
46
61
72
43
71
83
48
39
62
66
78
83
2247
FolkCultural
Show
11
5
6
9
5
9
8
5
5
7
6
8
10
237
WATSANCommittee
Meeting
495
230
305
360
215
355
415
240
195
310
330
390
415
11235
Mikingthrough
WATSANCommittee
495
230
305
360
215
355
415
240
195
310
330
390
415
11235
Rallythrough
WATSANCommittee
99
46
61
72
43
71
83
48
39
62
66
78
83
2247
ImamTraining
1030
m. CHAPTERS
LITERATURE REVIEW ON SOCMOB
m
i
HAPTER - 3: LITERATURE REVIEW ON SOCMOB
3.1 Introduction
j Two monitoring reports on the UNICEF assisted Rural Water Supply and Sanitation Project have- been available for our perusal. These reports cover the overall water and sanitation activities of the
project in question and have sections on social mobilization.
I 3.2 Monitoring by BETS and OCTA
j The findings of these two monitoring reports are furnished below:
Both the monitor ing studies reported relative lack of coordination among UNICEF, DPHE and NGOsj regarding implementation of field level SocMob activities. OCTA reports thatorientation workshops
J for WATSAN members were conducted by NGOs in most places without informing/ invi t ing DPHEofficials. This is alleged to have created misunderstanding. DPHE field officers are taking very little
] or no interest in holding WATSAN meetings. Better coordination between field level NGOs and] DPHE staff at the field level is recommended, UNICEF is also called upon to undertake greater
coordination.!
~j Both studies report that un ion parishad chairmen and members were not very keen about SocMobactivities. All the Union WATSAN committees have been formed. The orientations of the members of
> these committees have also been completed by the NGOs without involving theSAEs of DPHE. Outj of these committees only 61 per cent have been found active and 33 per cent meetings of the
committees were held in previous month of the moni tor ing. Implementat ion of activities l ike mik ing ,video show, rally, WATSAN fair and folk/cultural shows etc. have been of negligible proportion
j compared to the planned number. About 50 per cent of the UWC members interviewed have been1 found to be ignorant of the TOR of UWC.'o'
There were differences among districts regarding the types of SocMob activities undertaken. Comil laachieved highest target (82 per cent) in respect of Union level rallies, and Faridpur achieved highesttarget (100 per cent) in respect of village level miking. The districts of Patuakhali, Barguna, Jessore,Faridpur, Satkhira, Brahmanbaria, Kushtia, Gopalgonj, Comilla and Jhenaidah completed orientationtrainings as per plan.
There was still room for further motivation and sensitization. In many upalizas, health officers andUP chairmen were not taking enough interest in SocMob activities. Upaliza level coordination couldimprove the situation.
BETS reported that information on SocMob at district and upaliza levels was not available. Even theNGOs could not offer information on the latrines installed except in a few districts under their review.
It was also obseived that most of the NGO beneficiaries of latrines installation were found to beaware of hygienic matters, indicating better awareness b u i l d i n g among these people.
OCTA found that in the northern districts under its study. In the field.of SocMob through schools,orientation of teachers has almost been completed. However, no activity in this regard has yet beenundertaken in the field. This has happened due to the absence of follow up and accountability.
The activities of SocMob through Ansar/VDP have not yet been started in Nilphamari district due tonon-availability of funds. Ansar/VDP training for SocMob has been completed in Sunamgonj but thedesignated members of Ansar/VDP have not been trained.
\\PC1\PC1_BRepert-WNICEf-SoM2b\FmnlRepoftChaptiir-3
Almost al l the DPHE field level officials strongly feel that the SocMob activities are not being carriedout in the appropriate ways. According to them there ought to be co-ordination between NGOs, whocarry out these activities, and the DPHE field level officials. These officials also th ink that UNICEF isnot f u l f i l l i n g its role of monitoring and co-ordination.
Monitoring Report by Bangladesh Engineering and Technical Services (BETS), Apri l 1999 dual with20 monitored districts in southern part of the country.
OCTA Private Company Limited undertook monitoring of Rural Water Supply and SanitationProject. Their f indings of SocMob related activities covered 20 districts in the northern region of thecountry.
SocMob Activities
There is no co-ordination between DPHE and NGOs in imp lemen t ing the activities at f ield level .NGOs in most places conducted orientation Workshops for WATS AN members without informing/invit ing DPHE officials. This created misunderstanding. DPHE is taking very little or no interest inho ld ing WATSAN meetings.'OJ
Advocacy workshops both at upaliza and district levels of the districts visited have been completed.However, action plans drawn in the workshops have not been distributed to the participants ofworkshops in most of the places.
3.3 Completion Report of the Social Mobilization Programme by UNICEF, Bangladesh,1999
The UNICEF prepared a completion Report on Social Mobil izat ion in 1999. It w i l l be of interest toremember their findings on social mobilization.
The Social Mobilization project was successful in creating a greater acceptance of NGO-DPHEcooperation, a relationship that was facilitated by UNICEF. The relationship was problematic in thebeginning. However, it could definitely be considered as a stepping stone towards greater futurecollaboration between the government and the civil society. Besides, the l inks created with districtand upaliza level officials can be leveraged in the future. Institutional capacity of government andNGOs has increased significantly through training and orientation on social development.
The activities may have raised awareness, but they did not create the 'critical awareness' prerequisitefor behavioral development. Behavioral development is dependent on a complex set of factors andrequires sustained motivational efforts and other al l ied support. The time frame in the current socialmobilization programme was too short. Furthermore, needed motivational interventions could not beundertaken intensively and necessary follow-up could not be done due to institutional limitations.Overly emphasis was placed on capacity bui lding through trainings, orientations of governmentalofficials who themselves took little interest or were not motivated enough to undertake mobi l izat ionand motivational campaign at the grassroots. Perhaps, the use of a Facilitating Agency, working inconjunction with other grassroots NGOs, elected representatives, would have taken the Programmecloser to the grassroots people, especially women, and would have also drawn government officials inthe process through closer contacts, regular liaisons and close follow-ups.
Apart from init ial lapses due to staff turn over, NGO Forum did a commendable job in mobi l i z ing alarge number of trainers from NGOs and private organizations. Furthermore, NGO Forum also did avery good job in coordinating with and involving a large number partner NGOs to implement specificcomponents of the programme including advocacy workshops at the union level and installation of alarge number of latrines through motivational activities at the grassroots.
Monitoring done by NGO Forum was good but not of high quality. They should strengthen theirmonitoring cell with adequate well-trained staff members to do the job well.
It was generally agreed that there was a lack of close cooperation between the field level governmentimplementers and NGOs, between LJNICEF and DPHE and NGO Forum. Future programmes wouldhave to tackle this.
In conclusion it was submitted that the Social Mobilization Programme suffered a serious set-backdue to flood. The momentum of the Programme was suddenly lost. Field activities were disrupted,priorities got shifted and the total programmatic focus was diverted to flood relief and rehabilitation.Commitments of the government officials faded away, the add-on value of sequential Programmeactivities was lost. The synergistic impacts of the concentrated efforts could not be achieved.
3.4 Report on Communication Material Pre-testing and Qualitative Assessment of HAPTCImplementation Process by ORG-MARG Quest Limited December 02, 1999 (Submitted
! To: WES Section, UNICEF, Dhaka)
Hygiene Awareness and Product Information Campaign (HAP1C) is an intervention conducted by-i DPHE with the assistance of UNICEF. HAPIC is a small simulation of mobilization andI
communication campaign on sanitation, hygiene education and safe water use. The simulation wasj conducted in 4 unions, 2 in Gaibandha and 2 in Manikganj district from April to June 1999. Thej simulation involved a number of GO and NGO partner organizations.
j Purpose of the Study\
• To provide a qualitative analysis of the implementation "model" designed for HAPIC] (Hygiene Awareness and Product Information Campaign).i
• The analysis determines the quality and effectiveness of the interaction between GOB andj NGOs in p lanning and conducting social mobilization activities at the grassroots levels.
• The role of the facilitating and training agencies was examined as part of the overall projectin b u i l d i n g capacity of GOB and NGO partners in implement ing the project.
The communication materials were pre-tested among others as to comprehension of messages andvisuals the acceptability overall appeal.
The simulation study succeeded in drawing certain conclusions as to the implementation process ofthe social mobilization. These are:
• Two NGOs, Proshika and BRAG, gave a good account of themselves in implementingHAPIC among the stakeholders;
• Training and work plan, conducted/prepared by professional trainers, was acceptable to theparticipants; the training and workshops were participatory in nature;
• Proshika and BRAC were able to facilitate the overall process quite satisfactorily includingmaintenance of liaison with stakeholders from union to district levels, and documentation;
\\PC1\PC1_E\Repoii-MJNICeF-SocMob\FmalReporttChapter-3 j J
• The stakeholders at the upaliza and union levels were able to accomplish their tasks. Thedistrict level officers were busy with their day to day work but convinced about HAPIC;
• GO-NGO partnership was well accepted by all concerned;
« The HAPIC process seems to work in creating awareness about sanitary latrine or use of safewater etc.
Suggestions
• Strong monitoring system is suggested. Independent coordinators at union, upaliza anddistrict levels are suggested to ensure supervision, monitoring and coordination;
• Important personalities like journalists, youth club, elite (political, social etc.) should beincluded for overall community participation.
The report suggested some changes in other districts and recommended replication of the process ofHAPIC simulation in other districts.
The present consultants (HCL) will bear in mind the HAPIC process and suggestions of ORG-MARGQuest Ltd. in analyzing SocMob activities under review and in drawing their recommendations.
\\PC1\PC1_efteport-MJNICEF-SocMob\FinatReporHChapter-3
CHAPTER 4
FINDINGS OF THE STUDY
HAPTER - 4: FINDINGS OF THE STUDY
4.1 Introduction
As the methodology shows the findings of the study are based mainly on PRA/FGD and householdsurvey. PRA/FGD was undertaken in 3 districts, i.e. Kishoreganj, Sunamganj and Kushtia. In eachdistrict, the following groups were sought to be brought under the PRA:
1. User group;2. Non-user group;3. A & VDP, Volunteer and H&FPO;4. UWC & UPO;5. UpazilaNGOs;6. NGO-Forum;7. Trainer Group;8. Upazila Govt. Officials; and9. District Officials.
The detailed findings of the PRA/FGD of these groups are submitted as Appendices by districts(Appendices 3A, 3B and 3C). The summary findings are presented below under the following heads.
4.2 Advocacy Workshops at Different Levels
Advocacy Workshops were held at District, Upazila and Union Levels
4.2.1 Advocacy Workshop at District Level
Deputy Commissioner, Executive Engineer (DPHE), UNICEF representatives, Civil Surgeon, DeputyDirector (Family Planning), District Education Officer, District Information Officer andUNOs fromupazilas often participated in the district advocacy workshop. One such workshop was held in adistrict.
Three organizations cooperated in doing the spadework for the district advocacy workshop:
• DPHE performed the role of overall organizer;« NGO-Forum facilitated;• UNICEF offered direct cooperation.
The workshops were conducted in a participatory manner and the subject matter was appreciated byall the participants. There was positive response from all the participants and they readilyacknowledged the social desirability of the SocMob programme.
It was held that due to lack of general education among the population, health and hygiene awarenessis not of a high order in society, particularly in rural society. In such circumstances, socialmobilization for hygiene awareness and motivation was very much called for.
Representatives from different government departments spoke on the occasion and gave the assuranceof their cooperation with the SocMob programme. They also highlighted the resources available attheir disposal to undertake such interventions. Health and family planning offers spoke of their fieldlevel manpower. Deputy Director of the Islamic Foundation appreciated the plan to rope in services ofthe Imams in social mobilization for health and hygiene and felt that appeal to religious sentiment forcleanliness is a step in the right direction.
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Information on the district level Action Plan to be chalked out in the district advocacy workshopcould not be elaborated as most of the officials attending PRA claimed to be newcomers in the
'districts. However, they spoke of the plan to undertake upazila and union levefadvocacy workshops,which they sought to support through their departmental representatives. It may be noted that transferof officials could not be a reason for lack of awareness of a programme if it were taken with dueseriousness by the relevant office. There should have been enough documentary evidence of work inthat office.
4.2.2 Upazila Level Advocacy Workshop
Upazila level advocacy workshops were also held as planned in the three upazilas under review. NGOForum provided satisfactory facilitation. The workshop, one in each upazila, was participatory,readily appreciated by the upazila level officials and other participants who grasped the subject matterof social mobilization for sanitation, safe water, health and hygiene. Most of the participantsexpressed their desire to be a part of the social mobi l iza t ion process for hygiene awareness and he lpwith their manpower at the field level (H&FPO).
4.2.3 Outcome of the Advocacy Workshops at the District and Upazila Level
The advocacy workshops at the district and upazila levels had a cascading effect. The districtworkshops led to upazila workshops, which led to un ion level workshops. The follow-up actionappears to have been undertaken by the NGO-Forum and ind iv idua l NGOs. WATSAN Committeeswere not functioning in several places.
Advocacy workshops were held only once and its objectives appear to have been f u l f i l l e d . Theofficials and social elites at the district and upazila levels were exposed to the concept of SocMob andthey appreciated the objective and methodology of SocMob and gave the assurance of theirparticipation.
However, in one district of the three interviewed by the consultants, one or two officials came with arather drastically different methodology. They thought that UNICEF should give the project money toDPHE who shall be then placing the latrines in the villages. They were against advocacy workshopsand said that 2 villages could be covered with latrines, with the money spent on one such advocacyworkshop. They did not appreciate the need for high level sensitization.
4.2.4 Union Level Advocacy Workshop
Union level workshops were held in the unions visited for PRA/FGD. The SAEs often participated astrainers. This was only a beginning of the SocMob activities at the union level. More work wasplanned at grassroots level. Union level advocacy workshops appear to be well conceived in thescheme of things of SocMob. Beyond the union, there is scope to continue meetings at the village,school, 'uthan' and other grassroots levels.
4.2.5 Follow-up
Plan of Actions were sought to be formulated at workshops, but these were not followed up regularly.Absence of WATSAN committee at many union levels or the moribund condition of some upazilalevel WATSAN committees is an indications of this state of follow-up and monitoring.
The district and upazila level PRAs indicate that some mechanism has to be devised to follow upaction plans of advocacy workshops and other hygiene awareness bui ld ing activities
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Recommendation
In any future project or programme on hygiene awareness and motivation, the D.C.C & U. C. C shouldbe co-ordinating the interdepartmental activities at the district andupazila level respectively. DHPEshould have data and information on NGO activities and other departmental offices working for theSocMob programme. DPHE may be helped by some NGO in this facilitation of coordination, asDP HE does not have enough manpower at upazila and district levels.
The role of the UNOs and UP Chairmen in. respect of coordination has been appreciated by bothDPHE upazila level officials and NGOs at that level. UNO is in a position to influence and motivatethe Union Parishad Chairmen and Members and, therefore, may be encouraged to do so in relationto hygiene awareness building.
4.3 Training of Trainers
SocMob programme depends on elaborate training of the stakeholders at various levels. Traineesbecome trainers at subsequent levels. As the programme deals with the rural people who are not soeducated, the method of training assumes crucial importance. We have sought to evaluate the t ra in ingprogrammes at different levels of training.
Train ing programme went as per plan. The facilitators were competent.Thy could express their ideasclearly. Follow-up questions were raised in this participatory training course to examine if theparticipating trainees could follow the subject under discussion.
Trainees from different units of the programme had the fol lowing roles at the grassroots level:
• To move forward with WATSAN committee;• To further motivate the union WATSAN committee;• To train the latrine producers, ring and slab manufacturers;• Organizing sanitation exhibition in different centres inc lud ing construction of latrine inputs;« Motivating people for sanitary latrines and health awareness in 'LIthan baithak' (courtyard
meeting);• To bui ld awareness through Imams;« To discuss WATSAN programme in schools before teachers and students;• To help the distr ibution of sanitary latrines through soft credit terms.
iJ Tra ining modules were made available by BRAC.
4.4 Trainees as Trainers
Most people participating in training have subsequently worked as trainers in:
• Union level training;• Village development committees workshops as facilitator;• Orientation courses for Imams, out of school children, school debates on WATSAN
programme, etc.
Monitoring of training was done as w i l l be seen under section on monitoring later. NGO-Forum fromMymensingh also monitored their activities. Monitoring of t raining has also been done by the upazilaand the district level officials.
The A&VDP members responded to their training. One-day training was held for them and SeniorOfficials of UNICEF attended the training session. They also receive training on health and sanitationat Ansar Academy where DPHE and Health Department officials train them on these issues. The aimof this training at Ansar Academy is to enable them to talk to rural people on sanitation and hygiene.They were also trained by UNICEF and NGO-Forum personnel.
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Some Ansars and VDP members worked as trainers at the local level. In certain districts, SAE workedas trainers at UP or upazila level as they claimed to have learned the subject matter at district orupazila leve l t ra in ings .
4.4.1 Selection Criteria for Trainers
Selection criteria for Trainers: TOT was organized at 3 levels, i.e.:
• TARC;» District, upazila and un ion levels; and« At the level of school, field and country ("Uthan Baithak").
At all levels, some criteria based on proficiency, experience, training background, etc. wereconsidered. NGO Forum and UNICEF offered trainers at the TARC level. At the district, upazila andu n i o n levels, Mr. Mazharul Islam of the NGO Forum discharged his duties with ab i l i ty . NGO Forumappointed trainers on the basis of abil i ty and fitness for such training. Again, NGO Forum,Mymensingh selected trainers for village and field level in Pakundia upazila. The selections at alllevels were satisfactory. It was maintained that delivery, dict ion, ability to communicate, patience andexposure to the rural socio-economic life were taken as criteria besides general educationalbackground.
4.4.2 Outcome of Training
The SocMob programme has moved upto the village level. People's perception about SocMob iswidespread. They now crave for sanitary latrines. Without the hierarchical system of traininginvolved under SocMob, such a result could not be achieved.
4.4.3 Recommendation
The advocacy workshops and sensitization of the government officials and elite at the district andupazila levels may now be slowly phased out. Training for hygiene awareness may now be UP andvillage oriented. Besides awareness building and motivational effects, certain technical issues maynow be emphasized in training. These relate to the structure of the sanitary latrine including the roof,maintenance and durability of latrines. Durability is associated with the quality of cement, rods andmortar used and flood depth of the place of the latrine installed. PRA showed that people care tokn.ow about these aspects. The use of the gooseneck has to be further explained. Information onchildren 's defecation and subsequent washing may also be stressed at the grassroots.
4.5 Motivational Activities
4.5.1 Status
SocMob programme sought to motivate the rural people to adopt sanitary latrines, practice handwashing before meals and after toilet and to use safe water. To motivate, the knowledge base of thepeople or their hygiene awareness has to be improved. If the people know that diarrheal and otherwater-borne diseases could be avoided through use of sanitary latrines, dr inking of safe water andwashing of hands before meal and after use of latrine they may feel motivated to install sanitarylatrines, use tubewell water and practice hand washing.
However, mere knowledge may not be enough. A critical level of awareness has to be reached beforeadoption of hygienic practices is ensured. For this sustained motivational activities have to bepursued. They have to be reminded of the need for sanitary and hygienic practices from time to time.
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SocMob programme did try to motivate people with a package of motivational activitieslike: miking,meetings, folksongs, leaflets and posters. The programme also demonstrated the construction of ringsand slabs, publicized their distribution under interest free loans through NGOs, incentives to NGOsfor distribution of latrines, etc. An elaborate programme of training at several levels was organized.All these activities are well planned and well-thought-out.
However, the PRA with users in Kudalia in Pakundia upazila of Kishoreganj showed that only 4 outof the 1 1 users had heard miking in the village. Only 3 out of the 1 1 have attended fairs. Nonetheless,they have heard of the motivational activities going on in the area and felt motivated to accept thelatrines. Two-thirds of them listened to folksongs on WATSAN. They have seen posters and leaflets,radio and TV programmes on WATSAN. The outcome of the combined efforts at motivation coulddraw their attention to sanitary latrines even if they missed this or that motivational device. This orthat motivational device out of an array of devices worked with an user. Their motivation gotreinforced by several such motivational devices.
4.5.2 Communication Materials
The PRA showed that people, specially the users and non-users alike, found the audio-visual aidsappealing and communicative. Some of them watched TV programmes or listened to radioprogrammes on hygiene awareness. The folksongs were attractive and appealing. A TV documentaryinvolving an old grandfather with old habits about defecation and hand washing and a school goinggranddaughter and grandson was an effective communication. The one depicting "Sheva Nin, BhaloThakiin" (Take service, remain well) has been lauded by the people.
In course of PRA with users of sanitary latrines it transpired that wall posters, leaflets, fairs, folksongsand union or village level meetings have served to bui ld awareness and motivate people to accept thesanitary latrines.
The HAPIC study, which did more incisive work on communication materials, also found that mostpeople liked the communication materials. Shopkeepers and individual households like to display theposters or sandwich boards. The TV programmes of noted dramatist Humayan Ahmed were alsoappreciated. It has to be noted that in a continuous programme, a poster or dramatic intervention tendsto lose its appeal and lustre after a certain span of time. New items have to be routinely introduce.There is scope for research and study in this area. DPHE and some stakeholders thought that therewas room for improvement in this area.
4.5.3 Subsidies for Motivation
At the grassroots level, some people asked for free dis t r ibut ion of latrines due to the poverty of thelandless and other destitute groups.
4.5.4 Recommendation
Motivational activity should now be aimed at grassroots level dialogue ("Uthan Baithacks") forinstallation of sanitary latrine at several cost options for rings and slabs. The good work of displayingposters and leaflets and folksong and fairs, including radio and television programme shouldcontinue. The training programme could be considerably reduced. The scope for bringing throughUnion Parishad Members and Chairmen, peer pressure at the village level school teachers andstudents could be explored.
Free distribution is not recommended at this stage, as acceptance of sanitary latrine is mostlydependent on behaviourial change. Continued loan from NGOs or Grameen Bank may be tied up with
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installation of sanitary latrines. The supply pushed marketing practiced now might even yield todemand-pulled marketing significant changes in behaviour and attitude of the masses.
4.6 Opinion of DPHE, NGOs and Stakeholders on SocMob Activities
4.6.1 Department of Public Health Engineering (DPHE)
Discussion was held with top level DPHE policy formulators and implemented. It was held that withhigher per capita income and education level, the issues of water and sanitation inc lud ing sanitarylatrine would have been solved through people's choice exercised through the market and the acquiredknowledge of the people. However, with present poverty a programme to foster hygiene awareness isnecessary. It is held that the proportion of expenditures between hardware (rings, slabs etc.) andsoftware (publici ty materials and workshops/training) should be 90:10.
Monitor ing was sought to be done through BMDC and Planning Academy of GOB. However, as theNGOs were inducted by UN5CEF in 1998, monitoring was performed by NGO-Forum and DPHEonly .
DPHE experience shows that participation of the people's representatives at the union or grassrootslevel is a must for adoption of sanitary latrines. The example of Kengragesi un ion of Kolaroa upazilahas been cited in th is connection.
In Kalaroa upazila, a UP Chairman identified the households whose childrendefecated in open place without any reservation. He then called the relevantparents to the village markets and put social pressure on them or their guardiansto have pit latrines. The pressure worked and 100 per cent coverage of sanitarylatrines was accomplished in the Kengragesi union of Kolaroa upazila. On theother hand, examples are there where the UP Chairman and members had to bebrought to the programme after great persuasion. Without their commitment,SocMob will not proceed well.
DPHE on Involvement of NGOs
It was opined that DPHE was involved with WATSAN up to 1997. NGO-Forum was inducted besidethe DPHE by UNICEF in 1998. Result did not improve markedly. Then, UNICEF discontinued theprogramme in the midst of implementation process, which has left behind a considerable amount ofman and materials under the programme.
Recommendation on Future of SocMob by DPHE
At least a social mobilization segment should be attached to the HAP 1C programme. Donors are verymuch necessary for such programmes, which do not yield direct revenue to government. UNICEFshould come forward with greater stride. DPHE seeks assistance from UNICEF because it is awelfare-oriented donor. The communication package should be with experienced firms and people.The softwares developed for the radio and television are conducive to the progress of the programme.
DPHE thought that sanitation and hygiene is a continuous education. Some people will alwaysbackslide when the rings break or others may not come forward due to lack of will power. Therefore,some institutional arrangement should be developed with the UPs and schools for the purpose ofm-otivation.
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DPHE on Research Strategy
DPHE spoke for a need for research in the field. Sanitary latrines in the highlands and low lands arenot the same. In Sunamganj, sanitary latrines were placed in dry season with a certain elevation to bewashed away in the next flood. Monitoring of the quality of rings is also necessary.The effect of pit latrines on sub-soil water should be monitored, A research programme on theenvironmental aspects of pit latrines should be initialed.
District and Upazila Level DPHE (XEN and SAE)
The Executive Engineers and Sub-Asstt. Engineers at the district and upazila levels respectively feltthe need for belter coordination of the SocMob activities. It was felt that district level coordinationshould be held with the D. C and the allied government officials and NGOs at regular intervals alcertain fixed days. The same procedure may be followed at the upazila level with UNO as thechairman.
At the moment monitoring by the SAE at the upazila level is performed through collection of month lyreports of the SocMob related activities of such offices as H&FP or TEO. But this is not sufficient forcoordination. Some DPHE officials opined that the expenditures incurred on advocacy workshopscould be economized. Upazila level SAEs sometimes felt that there was no need for separate categoryof trainers at the u n i o n level as they are able to train people at the un ion level.
4.6.2 NGO Opinion
A. NGO-Forum Headquarters
In the opinion of the NGO-Forum headquarters, Dhaka, the SocMob programme is a necessaryprogramme and found this view shared by all of their partners. The forum has helped with facilitatorsand trainers in workshops and trainings. They sent t raining modules as per necessity to the fields.Core programme staff of the NGO-Forum has worked for the WATSAN programme. They haveperformed WATSAN programme activities while undertaking their main job. If programme specificstaff could be employed, the job could be performed better. Perhaps senior most executives of NGO-Forum could not work intensively but core staff visited and monitored the programme sometimesrandomly and sometimes purposely.
According to them, UNICEF has not done anything in connection with latrine construction, evenfinancially. However, they have given incentive money per family of Tk. 15/20/30 depending oncircumstances through NGOs. They think that motivational activities fell somewhat short ofstipulation. However, people have known of SocMob. They think that coverage could be known aftercounting installations.
NGO-Forum is continuing sanitation work as routine work even though SocMob remains terminated.
B. NGO-Forum Representatives at District Level (Kishoreganj, Sunamganj and Kushtia)
The PRA succeeded in eliciting observations and opinions from the representatives of the NGO-Forum and other partner NGOs in the 3 districts under review. The recommendations of the NGO-Forum at the district level are worth noting.
NGO-Forum claimed that it, along with the partner NGOs, moved ahead with the programme takingalona; DPHE with it.
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NGO-Forum noted that upazila level WATS AN committees were not in existence in many upazilasand Ex-officio Chairmen and Secretaries did not know that they were assuming those positions.
NGO-Forum at the district level opined that SocMob programme did not have enough time,speciallywith the dislocation caused by floods in 1998. The programme has reached the people but fell short ofa mobil izat ion. They opined that the programme stopped at the midway when 51 per cent progresshad been made.
Recommendation of the District Level NGO-Forum
The NGO-Forum there advocated extension of the training of the trainers with trained trainers.Monitoring will be better performed through NGOs. SocMob should be considered as a specialprogramme and NGOs and Govt. offices should work earnestly for it.- The associated govt. offices,besides DHPE. should give particular attention and help the programme. It was noted that educationofficers at the district level should participate more actively and write to rural schools asking them toparticipate in the programme.
NGO-Forum representatives further noted that people are committed to the programme and somepeople opined that if necessary VGD programme of GOB or loan operations of NGOs should be liedup with latrine installation.
NGO-Forum at the district level submitted the following for better coordination of the NGOs. DP HEand other cooperating agencies:
• UNO has to assume the prime role at the upazila level and participation in the monthlymeeting of the NGOs, DP HE and other associating agencies be ensured:
• UP Chairman and Members could be followed-up bv the UNO to ensure their meaningfulparticipation in the WATS AN programme;
• Education offices at the district and upazila level should write letters to the schools askingthem to participate in the programme:
• The Civil Surgeon of the district and Upazila Health Offices should be more involved in theprogramme:
« Family Planning, A&VDP officials should be coordinated in the work through the UNO andDPHE.
C. Upazila Level NGOs
Their views on coordination with upazila level officials are akin to those of the district level NGOForum.
The upazila level NGOs are quite aware of the role they are playing in latrine distribution and had thefollowing to submit in this connection. An important element in the programme is the manufacturingof rings and slabs. These are distributed to acceptors under an interest free loan. At the grass rootslevel, the NGOs are involved with this work along with a few private sector individuals. Even thecommon people at the village level (users and non-users) felt that the programme is run by the NGOs.
In one upazila under review the NGOs have fared excellent in the fulfillment of their targets, speciallyBRAC and PBK. Another national NGO achieved 60 per cent of the target in that upazila due to theirshortage of funds.
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4.6.3 Stakeholders Opinion
In this category are included the district and upazila administration officers, school teachers, Imamsetc.
The D.C and UNO participated in the respective advocacy workshops and affirmed the relevance ofSocMob to the national development process, particularly in improving health, environment andsanitation. However, there are limitations on their time and they could be involved in this programmeif the follow-up and pursuit come from the XEN, DPHE at the district level and SAE, DPHE at theupazila level. These officers gave unreserved support to the programme.
The district level health and family planning officials also supported the programme and felt that theirfield level officials are already involved in motivational work (family planning) and could work onSocMob.
Upazila level officials showed their wil l ingness to cooperate. Education officers were w i l l i n g to he lptheir school teachers and students.
District Information Officer informed that his apparatus highlighted SocMob programme in itspublici ty work. Nevertheless, the SocMob programme needed more active participation.
The Deputy Director of Islamic Foundation also showed keen desire to influence the Imams toparticipate in the programme. Goodwill for the programme is evident and may be exploited to makeproper use of the latent forces lying dormant in them.
Union Parishad chairmen and members, school teachers and students also supported the programme.
4.6.4 Other Partners and Allies
There was widespread goodwill and support for the programme. Private producers of latrineequipment offered cooperation. Youth groups, high school teachers and students etc. offered tovolunteer their services for SocMob. Folksong singers were equally wi l l ing to cooperate.
4.7 Monitoring Activitiesto •
In the execution of any project or programme, monitoring and evaluation assume great importance.Such monitoring shows if the interventions are going on smoothly, if the activities are on the righttrack and if some changes are to be effected to achieve the desired objectives and goals.
The objectives of the SocMob programme of 1997-99 were to increase sanitary latrine use, to bringabout changes in hand washing, after latrine use and before meal, and to reduce the use of pond waterfor domestic purposes. The goal is to have healthy children and population with drastically reducedepisodes of waterborne diseases.
The activities included advocacy workshops and training at different levels, publicity through miking,distribution of leaflets, placing of posters, holding of fairs and exhibitions, folksongs, provision ofradio and TV materials etc. manufacture of materials for latrines. Activities also included provision ofincentive money through NGOs for installation of sanitary latrines.
The monitoring activities undertaken were not designed to relate inputs-outputs-and effects-impactsequence of project evaluation in a logical framework. In the absence of such information, theconsultants could only examine the activities performed in relation to the implementation plan.
Discussion with cross-section of stakeholders yielded the following information on monitoring andfollow-up.
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DPHE at the district and upazila level did some follow-up with their limited manpower. Their follow-up consisted mainly of collection of information from upazila level health, family planning, BRDB,A&VDP officials through the good office of the UNO. These associated offices at the upazilaheadquarters have their field level workers who are in a position to follow-up facilities for theSocMob activities in the countryside and some follow-up did occur through them.
4.7.1 Monitoring by NGO-Forum
NGOs appear and claim to be better equipped with facilit ies for monitoring. They have moni tor ingextended up to the grassroots. The framework for monitoring extends from the top to the bottom.
I n d i v i d u a l NGOs have used their monitoring formats. Besides, the NGO-Forum has also used itsmonitoring device to observe the funct ioning of SocMob. They have suggested ways and means tosolve problems and offered cooperation.
; However, NGOs did not systematically monitor the programme. Views of the NGO Forum onj monitoring are avai lable above (Section 4.6.2).
j Recommendation:\
Monitoring should constitute an integral part of any future programme of social mobilization.> Services of UNO, SAE/DPHE, UP chairman and NGOs may be harnessed for such monitoring. A
~~j unified monitoring system should be agreed upon and the monitoring central project authority should' co-ordinate monitoring.
j 4.8 Construction of Latrines by NGOs1
It was stipulated in a revised target of SocMob programme that 122 NGOs would install 306,271i latrines in 32 intervention districts. Status report of NGO Forum, dated, May 27, 1999 showed that 98I per cent of the latrines have been installed by the NGOs.;
However, NGOs have latrine construction activities independent of SocMob programme. This isi demonstrated by the NGO Forum statement that they are very much in their sanitary latrine! programme inspite of the termination of SocMob.
] In order to augment and facilitate supply to the far-flung villages,NGOs quite often established sub-j centres in addition to the upaziia-based centres. People at the grassroots level think that NGOs are the
prime movers in the sanitary latrine business. The NGOs could not furnish any information on the, overall coverage of sanitary latrines in the intervention upazilas or districts c la iming that suchj information would require proper surveys. Besides NGOs, private sector was also supplying sanitary' latrine equipment in the market. Monitoring of distribution could be strengthened.
i ' Ind iv idua l NGOs reported no problem in supplying latrine equipment except one major NGO, which| experienced some financial difficulties in one upazila under review.
/i 4.9 Coverage of Sanitary Latrinesj
4.9.1 Progotir Pathey Data
; There is no benchmark survey to monitor the coverage of sanitary latrines with uniform samplingi design.'&"
The 'Progotir Pathey' mentioned that it has survey data relevant for October 1997 to October 1999,from the 1997, 1998 and 1999 volumes. It is seen that the number of sanitary latrines in theintervention areas increased by only 5 per cent between 1997-99 compared to 1.3 per cent for thewhole of rural Bangladesh for the same period. $
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The rates of growth of the intervention areas vis-a-vis the rest of rural Bangladesh may be seenbelow:
Years SocMob (32 District)* All Urban/Rural Bangladesh
1997-98 1.84% - 7.7%1998-99 3.1% - 0.2%1997-99 5.0% - 8%
Source: Progolir Pathey (Compiled)
Following the information of Progotir Pathey, there is some modicum of growth of coverage ofsanitary latrines in the past 2 years. Nonetheless, it is nowhere near the growth rate of 1 5 to 20 percent expected in the 1997-99 SocMob programme. Besides, there is some sampling error in ProgotirPathey data. In the 1998 survey, 10 districts showed a negative growth while in 1997-99. 13 districtsshowed negative growth out of 32 districts. These are sti l l the best available data.ti1
4.9.2 Household Survey
The household survey covers only 120 respondents from 6-districts chosen randomly out of the 32intervention districts and it shows a coverage of 49 per cent. The sampling error in such a survey w i l lbe appreciated. In fact, in this study, emphasis was put more on focus group discussion rather than onsampling survey.
4.9.3 Focus Group Discussion
Focus group discussion showed that sanitary latrines were more widespread than before, but anyestimate of coverage was not readily available. NGOs opined that without a representative samplesurvey no such estimate could be offered. Considering the three districts under FGD, Sunamganj withlow coverage, Kishoreganj with medium coverage and Kushtia with relatively high coverage, it wasopined that around 39-40 per cent of the households had sanitary latrines.
4.9.4 Findings FROM Case Studies of Users and Non-users
Twelve case studies, six on users and another six on non-users, are presented in Appendix-IV.
It is evident that the message of sanitary latrine, hygiene and pure water has reached the countryside.There are families who installed sanitary latrines before SocMob had started. Some families are beingmotivated by SocMob activities. Most of the families, users and non-users alike, reported Radio/TVto be the effective means of communication on ScoMob. Adoption of hygiene practices is abehavioral phenomenon and some persistent push and promotion may be necessary.It is noted that users of sanitary latrine belong to trade/business and service holder famil ies. Non usersare mostly landless workers, except a chaukidar or a teashop owner. And they propose to havesanitary latrine in near future in spite of relative financial diff icult ies.
All non-users under the case studies are aware of the baneful effects of indiscriminate defecation orunsafe water. Only one non-user, the chaukidar, confessed to be not sufficiently motivated or awareas yet to have a sanitary latrine, though he has knowledge about sanitary latrines. He heard of that atthe union parishad meetings. But he claims to be not sufficiently aware or motivated. Nevertheless, heproposed to have one soon enough. For most non-users, poverty is the stumbling block. Non-usersseek subsidized or free latrine equipment.
Compiled from data for 32 districts weighted by household data for individual districts
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J 4.10 Net Effect of SocMob
This-phenomenon has raised a conceptual question. How much of the increased latrine coverage is to, be ascribed to SocMob? In fact, users informed that they have received latrine materials from otherI sources than NGOs (Table 5.9.2). Some of the respondents of case studies and household survey1 reported use of sanitary latrines before the initiation of SocMob programme. Nevertheless, a certain
spurt took place with SocMob. Again, though SocMob remains terminated, NGOs are continuing with; supply of sanitary latrine equipment. SocMob motivational campaign must have helped in this| respect.
• The synergistic aspect of the issue is somewhat intractable. Sanitary latrine use is a function of:
1 • Poverty level;• Cost of equipment and installation;
| » Distribution by NGOs by mainly SocMob; andi « Knowledge, awareness and motivation
i SocMob cannot influence poverty level. It has marginal to no influence over costs/price through itsi monitoring of activities of NGOs and other private manufacturers. The remaining issue pertains to
knowledge, awareness and motivation. Knowledge comes from SocMob to a great extent, thoughsome people may have known of the necessity of sanitary latrine or pure water before the emergence
__j of SocMob. Nevertheless, one casual observer wi l l get the impression that SocMob has been aJ success in terms of k i n d l i n g the knowledge base, awareness and motivation of a significant section of
the people. Table 5.18 shows that 80 per cent of the respondents are aware that hand washing withj soap before meal may prevent diarrhea. Benchmark data are not available to compare the changes, but| some credit must be ascribed to SocMob activities. All these publicity did not go in vain. Again,
people like to follow their neighbors. Hence, demonstration effect also worked to increase the^ adoption of sanitary latrines. They saw others adopting it. Hence, they did it.
Recommendation:
1 In future projects of this nature, it will be advisable to have a benchmark survey, so that monitoring\ and evaluation may be facilitated. A logical framework may be added to distinguish between inputs-
outputs and effects/impacts.
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CHAPTER 5
ANALYSIS OF THE HOUSEHOLD SURVEY
HAPTER - 5: ANALYSIS OF THE HOUSEHOLD SURVEY
Major findings of the household survey have..been used in. the previous chapter. A detailedresume of the household survey is offered below in this chapter. The tables are available inAppendix- 5.
The household survey was conducted with 120 respondents in 24 villages of 12 thanas of 6 districts.Each v i l l age had 5 respondents, randomly selected. This survey methodology and the number ofresponding households were agreed upon by the UMCEF and consultants.
5.1 Distribution of Household as to Household Head and Gender
Fifty Two per cent of the respondents were household heads wh i l e 48 per cent were other members ofthe family (Table 5.1).Sixty Two per cent of the respondents were male, the rest females (Table 5.2).Tables referred to in this chapter are available at the end of this chapter.
s.7. Sanitary Latrines
Distribution as to Type of Latrines: In these villages, 49.1 per cent have sanitary latrines (ring slabs8.3 per cent, pit latrine 40.8 per cent), whi le 53.3 per cent did not. The latter had hanging latr ines (45per cent) or indulged in open defecation (1 8.3 per cent) (Table 5.4). Figure - 1 shows the percentagein column chart. Mult iple answers were possible. Hence, the total percentage may be more than 100per cent. Comparison with data from Progoter Pothey may be seen under Section 4.9 above.
Figure - 1
Distribtuion of Households by Type of Latrine Used
Ring Slab Pit latrine Hanging Latrine Open DefecationPlance
i Percentage
Pit latrines are primary steps towards sanitary latrines, often made with a cover slab made of concreteor bamboo/wood placed on earthen pits dug out for defecation. The rings seek to hold the earth up toa certain depth. Water sealed latrines are not common, hence not identified separately. In "ProgotirPathey" publication of BBS/UNICEF water sealed latrine where the goose-neck is broken is treated asa ring slab latrine.
Place of Defecation of Children: 3 - 5 Years: Eighty-two.respondents replied to this question. Ofthem 39 respondents or 48 per cent reported "defecation any where" showing great ignorance aboutthis health hazard. Only 28 per cent reported use of latrine and 24 per cent reported specific place(Table 5.16). Figure - 2 shows that social mobilization can play a great role in reducing thisindiscriminate defecation by children belonging to the 3-5 age groups.
\\PC I\PC l_E\Report-t\UNICEF-SocMcb\F'mal Report\Chapter-5.doc 25
Figure - 2
P l a c e of D e f e c a t i o n of 3-5 Y e a r Old C h i l d r e n
Aimvhcrc ctsc
gj P e r c e n t a g e
Ownership of Latrines: 64 per cent reported full ownership of latrine of some type (except opendefecation) while 19 per cent reported sharing latrines with others, one per cent reported access tolatrines not fu l ly owned or even shared (Table 5.6). Sixteen per cent reported no latrines (opendefecation). Open defecation appeared to be only half the national average of 30 per cent for ruralBangladesh in 1997 (Progotir Pathey, Page - 80).
Income and Latrine Ownership: Ownership of latrine appears to be associated with householdincome. 100 per cent of households earning Tk. 5000 per month or more have sanitary latrine withdiminishing rates as income decreases. (Table 5.5). Figure - 3 shows the relationship betweenincome level and percentage of households having sanitary latrines.
Figure - 3
Level o f Month ly I ncome and P o s e s s i o n o f S a n i t a r y Latr ines
=1500 1500-2500 2500-3500 3500-5000 5000-7500 Above 7500
Monthly Income Level
Time of having Latrine: Among the users of sanitary latrine, 52 per cent started using such latrines 3years before the survey, while 48 per cent started using in the last 3 years (Table 5.7). Thus, sanitarylatrine use among the respondents of the survey almost doubled in the course of the last three years.
\\PC 1\PC 1 _E\Report-t\UNICEF-SocMob\Fina] Report\Chapter-5.doc 26
Motivation of SocMob: Acknowledgment of motivation by SocMob for construction of sanitarylatrine was reported by 59 per cent of the respondents having such latrine. The remainder 41 per centdid not (Table 5.8). This figure of 59 per cent includes respondents who installed sanitary latrinesbefore 1997. Response of the respondents who installed such latrines in the last 3 years would havebeen more meaningful .'o'
Assistance for Latrines: 17 people reported receiving assistance from others for constructing latrines(Table 5.9.1).
Thus, only 29 per cent of the sanitary latrine users reported receiving assistance for latrines, mostlyfrom NGOs and teachers/students (Table 5.4.2). Thus almost 70 per cent of the sanitary latrine usersinstalled such latrines without assistance from others. However, if we consider the acceptors of thelast 3 years only, 60 per cent may be considered to have received assistance for latrines. The factremains that some people are capable of instal l ing latrines without assistance from NGOs(Table 5.7and 5.9.1 and 5.9.2).
Advice to Construct Latrine: 33 per cent of the respondents received advice from others toconstruct latrines whi le the rest 67 per cent did not receive such advice (Table 5.10.2). Among thosereceiving advice, 33 per cent received advice 3 years ago while rest 67 per cent received advicewithin the last 3 years (Table 5.10.3).
Technical advice for sanitary latrines was received by 28 per cent of respondents having such latrineswhi l e others 72 per cent did not receive technical assistance (Table 5.11.1).
Financial Assistance for Latrines: Nature of assistance may be divided into:
• Financial• Input supply.
Financial assistance was received by 10 per cent whi le own funds were used by 90 per cent. Again 88per cent of respondents used inputs from own sources, whi le 12 per cent received these as loan ordonations (Table 5.12.1).
Technical Assistance for Latrines: Nature of technical assistance is seen in (Table 5.11.2) and(5.12.3). Most of the assistance was for laying slab (40 per cent). NGOs gave 75 per cent of the T.A.
The nature of technical assistance for sanitary latrines reveals some insight into the whole operation.Only 16 or 28 per cent of total users reported receipt of technical assistance (Table 5.11.1). Thus,sanitary latrine is something that does not stil l require high level technical knowledge. The social elitethat has established sanitary latrines have learned about it through demonstration effect or generalknowledge. This finding lends support to the view that social mobilization for awareness b u i l d i n g andmotivation is the prime mover in installing latrines.
5.3 Hand Washing
Source of Information on Hand Washing: 87 per cent of respondents have heard of the need forhand washing after using latrine. Only 13 per cent have not heard of it. The sources of information onhand washing after using latrine may be seen in (Table 5.13). The highest source is 'others' (38 percent), followed by miking in the locality (31 per cent). Almost 50 per cent heard of it 3 years ago andthe rest 50 per cent heard about it in the last 3 years (Table 5.14). This doubling of the informationcoverage in the last 3 years is a good commentary on the SocMob programme. Figure - 4 may beseen for distribution of sources of information for hand washing after using latrine.
\\PC1\PCI E\Reix>n-f\UNICEF-SocMob\Fiiial Rennrt\rh»ntpr-< ri^r-
Figure - 4
Pr inc ipa lSources of lnformat ion for Hand Washingafter Using Latr in e
Means of Washing Hand: Everyone washed hand after defecation whether they have heard of thehygienic method or not. Around 44 per cent washed hand with soil, followed by ash (36 per cent),soap (35 per cent), only water (8 per cent) and others (2 per cent) (Table 5.15). The claim to washhand with soap in rural areas was sought to be checked by the request to show the kind of soap theyused. Hence, the answer may be dependable. Figure - 5 shows the findings on means of washinghands after defecation. Hands washing with soap remains at 35 per cent, below SocMob target of 40per cent.
Figure - 5
M e a n s o f W a s h i n g H a n d s a f t e r Defeca t ion
Soap Only Waloi
Method of Washing Hands after Cleaning the Defecating Children: Ninety four responses wereavailable. Of these 37 per cent used soap, 28 per cent ash and 26 per cent soil. 23 per cent reportedusing only water to wash hands after cleaning the bottom of the defecating child. This is aphenomenon, which requires further improvement (Table 5.17).
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Hygienic Practices to Prevent Diarrhea: 120 responses were analyzed. Multiple answers, werepossible in this question. About 80 per cent reported that washing hands with soap before meal wasneeded to prevent diarrhea. About 60 per cent reported washing hands with soap or ash afterdefecation, 23 per cent asked children to defecate in a specific place and 50 per cent recommendeduse of tubewell water for all purposes (Table 5.18) as measures to prevent diarrhea Figure - 6.
Figure - 6
H y g a n i c P r a c t i c c s as M e a s u r e s to P r e v e n t D ia r r o h ea
3 e re e n I a u e
The above responses indicate low to high level awareness about measures to prevent diarrhea. Lowlevel awareness about defecation of infants is particularly noteworthy. Awareness has to be improvedregarding hand washing after defecation or using safe water for household work.
Best Time for Washing Hands: Respondents were asked about the best time for washing hands. Allthe 120 respondents replied to the question. Of them 86 per cent said the best time for washing handswas before meal while 13 per cent responded that the best time was after using the toilet. Only 2 percent said the best time was after cleaning the bottom of the children (Table 5.19). See Figure - 7.
Figure - 7
B e s t T i m e f o r W a s h i n g I I a n d
^ P e r c e n t a g e
There appears to be some misunderstanding and lack of knowledge here. May be the question wassomewhat misleading. The question should have been on the appropriate time for hand washing. Inthat case, respondents could have reported all three possibilities, i.e. before meal, after defecation andafter cleaning the bottom of the child. The choice is not for the best time, but for the appropriate time.
5.4 Use of Water
Intervention/Information on Drinking Water by Person or Organization: Respondents wereasked if they were advised on drinking water by any person or organization. 120 respondents werealmost equally divided. Only 51 per cent answered that they have been advised about drinking waterwhile 49 per cent answered that they received no information on drinking water (Table 5.20).
The respondents who stated to have been advised on drinking water were asked as to the source ofsuch information and advice. 61 per cent mentioned the health worker, 48 per centNGOs, 3 per centImams (Table 5.21). Multiple answers were possible.
Source of Water for Domestic Use: Questions were asked as to the sources of water for drinking,cooking, and washing utensils and bathing.
Drinking: 100 per cent reported tubewell as the source for dr inking water.
Cooking: 61 per cent used tubewell water for cooking as against 37 per cent reporting pond/riverwater for the purpose. The reasons for not using tubewell water could be explored in future studies.Enhanced use of tutewell water for cooking will improve the health status of the people.
Washing Utensils: About 58 per cent used pond/river water for washing utensils while 38 per centused tubewell water for the same purpose. There were 2 to 3 per cent respondents using earth holewater for these purposes. Use of tubewell water for washing utensils could be improved.
Bathing: While 39 per cent used tubewell water for bathing about 58 per cent used pond/river waterfor this purpose.
3.3 Witnessing SocMob Activities
Witnessing to SocMob related Activities: Eighty-nine responses or 75 per cent of the respondentswitnessed SocMob activities. Among these 89, miking was reported by 46 per cent, the most effectivemeasure to reach the people. Video film shows are reported by 14 per cent, both cultural functionsand meetings on health affairs by 11 per cent, mobile WATSAN fair by only 1 per cent. A largesection, 32 per cent, reported other sources as vehicles for their knowledge of WATSAN activitiesTable-5.22. (Figure-8).
Figure - 8
Witness to SocMob Related Activities
\\PC 1 \PC 1 _E\Report-f\UNICEF-SocMob\Final Rcport\Chapter-5.doc 30
Witness to the Presence of Sanitary Worker in the Locality
Sanitary worker here meant people working for motivational purposes (software) or bui ldingtubewells and latrines (hardware).
89 respondents or 75 per cent witnessed sanitary works in the locality (Table 5.23). This answer hereis the same as in the previous question.
5.6 Imams' Participation in SocMob
Questions were raised as to the participation of the Imams in sanitary work. 34 per cent reported thatthey were aware of it, the rest 66 per cent did not know about it (Table 5.24.1). Almost all of thepositive respondents said Imam's participation was effective in awareness raising about water,sanitation and hygiene.
Recommendation
J Future benchmark surveys should distinguish between hand washing methods;
1 • Before meal: andj « After toilet.
\ Distinction may be made between water use for cooking and washing utensils. Distinction may also\ be made between an individual's awareness/knowledge on the one hand, and actual practice on the
other.
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Table 5.1 : Distribution of Respondents by Household head
Household headYesNo
Total
Number62
58
120
%51.7
48.3
100.0
Table 5.2 : Distribution of Respondents by Gender
GenderMaleFemaleTotal
Number74
46
120
%61.738.3
100.0
Table 5.3 : Distribution of Respondents by Income
Monthly Income In Tk.<=15001500-2500
2500-3500
3500-5000
5000-7500
Above 7500
Total
Number2534
26
234
8
120
%20.8
28.3
21.7
19.2
3.36.7
100.0
Table 5.4 : Distribution of Households by Type of Latrine used
Type of LatrineRing SlabPit latrineHanging latrineOpen defecation place
Number10
494222
%8.3
40.8
35.0
18.3
1. Note : Multiple Answer was Possible
Table 5.5 : Distribution of Households by Type of Latrine used and Income
Monthly Income
Total
<=1500
1500-25002500-35003500-50005000-7500Above 7500
# of Sanitary——— tatrine ———Latrine
71114
144
8
58
Total # of
HH2534262348
120
% of SanitaryLatrine
, 28.032.4
53.8
60.9100.0100.048.3
Table 5.6 : Distribution of Household by Ownership of Latrine
OwnershipSelf
Share ownershipOthersNo Latrine/Open defecation PlaceTotal
Number7723
1
19120
%64.2
19.2
.815.8
100.0
Table 5.7 : Time Starting use of Sanitary Latrine
TimeWithin 3 YearsBefore 3 YearsTotal
Number283058
%48.351.7
100.0
Table 5.8 Acknowledgement of Motivation by Socmob for construction ofSanitary Latrine
MotivationYesNoTotal
Number34
24
58
%58.6
41.4
100.0
Table 5.S.1 : Assistance for Constructing Sanitary Latrine
MotivationYesNoTotal
Number174259
%28.871.2
100.0
Table 5.9.2 : Source of Assistance for Constructing Sanitary Latrine
ResponseTeacher/Student/NGOOthersNon ResponseTotal
Number2861
17
%11.8
47.1
35.3; 5.9
100.0
Table 5.10.1 : Others Showing interest in Sanitiry Latrine
ResponseYesNoTotal
Number j %4080
120
33.3• 66.7
100.0
Table 5.10.2 Advice from Others to construct Sanitary Latrine
ResponseYesNoTotal
Number3981
120
%32.567.5
100.0
Table 5.10.3 Time of Receiving Advice
ResponseBefore 3 YearsWithin 3 YearsTotal
Number132639
%33.366.7
100.0
Table 5.11.1 : Receipt of Technical Assistance for Construction of SanitaryLatrine
ResponseYesNoTotal
Number164258
%27.6
72.4
100.0
Table 5.11.2 : Nature of Technical Assistance For Construction of SanitaryLatrine
ResponseDigging PitLaying SlabConnectingConstruction of shed on latrineOthers
Number3836
2
%15.040.015.030.0
10.0
1. Note : Multiple Answer was Possible
Table 5.12.1 : Nature of Assistance Vis -a-vis own Resources
AssistanceFinancial
input
Total
LoanDonationSelfloan(Ring Slub)Bamboo/WoodSelf
Number33
52
34
5158
%5.25.2
89.7
5.26.9
87.9; 100.0
Table 5.12.2 : Sources of Assistance.
ResponseNGOUPTotal
Number527
%71.428.6
100.0
J
Table 5.13 : Principal Sources of Information for Handwashing after Using latrine
ResponseVidio Film ShowCultural FunctionMiking in the LocalityAssembly in the localityMovile Watson FairPrevious KnowledgesothersNot RearedTotal
Number38
3793
284616
120
%
2.5
6.7
30.87.52.5
23.3. 38.3
13.3
100.0
Table 5.14 : Time of Receipt of Information on Hand washing
ResponseKHA211
Total
Within 3 YearsBefore 3 Years
Number5252
104
%50.050.0
100.0
Table 5.15 : Means of Washing Hands after defecation
ResponseAshSoilSoapOnly waterOthersTotal
Number435342102
120
%35.844.2
35.0
8.3
1.7
100.0
Table 5.16 : Place of defecation of 3-5 Year old Children
ResponseLatrineAnywhere elseSpecific Place
Total
: Number, 23' 39
20
82
%28.0
47.6
24.4
100.0
Table 5.17 : Method of cleaning hands after Cleaning Children:
ResponseAshSoilSoapOnly waterOthersTotal . :
Number212427
221
82
%25.629:3
32.9
26.81.2
100.0
Table 5.18 : Hyganic practices Measures to Prevent diarrohea
ResponseWashing Hand with soap before mealWashing Hand with soap or ash after DefecationMake Infents to defecate in specific PlaceUsing tubewell water for all household workOthersTotal
Number967027604
120
%80.058.322.550.03.3
1-00.0
Table 5.19 : Best time for Washing hand
ResponseBefore MealAfter DefecationAfter children CleaningTotal
Number103
152
120
%85.812.51.7
100.0
able 5.20 : Intervention/Information on Drinking Water by any Person or Organizatio
ResponseYesNoTotal
Number6159
120
%50.849.2
100.0
Table 5.21: Source of Information on Drinking Water
ResponseNGOHealth WorkerImamothers
Number29372'1:
%47.560.7
3.31.6
5.22: Witness to Socrab related Activities
Movile Watsan hair/txhibitionCultural FunctionAssembly on health affairsMiking on Health affairsVidio film showsOthersTotal
Number1
101041122889
' %.8
8.38.3
34.210.023.3
100.0
Page 1
5.23 : Witness to the Presence of Sanitary Workar in the locajity
Movile Watsan hainkxhibitionCultural FunctionAssembly on health affairsMiking on Health affairsVidio film showsOthersTotal
Number- 1101041122889
%.8
8.38.3
34.210.023.3
100.0
Table 5.24.1 : Imam's Particifation in Sanitary Work
ResponseYes
NoTotal
Number4080
120
%33.366.7
100.0
Table 5.24.2 : Imam's Particifation & Effectiveness in Concious
-Hi
ResponseYesNoTotal
Number119
1120
%99.2
.8
100.0
Table 5.25 : Water Sources for Domestics Purpose
I ubewellEarth HolePond/RiverTotalTubewellEarth HolePond/RiverTubewellEarth HolePond/RiverTotal
No. | %88
329
12073
344464
69120
73.32.5
24.2100.060.8
2.5: 36.7
; 38.33.3
; 57.5I 100.0
CHAPTER 6
LESSIONS LEARNED FROM PARTNERSAND ALLIES
^>
HAPTER - 6: LESSONS LEARNED FROM PARTNERS AND ALLIES
6.1 Introduction
The SocMob programme has succeeded in creating some measure of hygiene awareness among themajority of the people in 32 districts of Bangladesh, where the programme has been in operation forthe last 3 years. These people aspire to have sanitary latrines and increasingly practice hand washingbefore meals and after using toilets. It is distributing latrine equipment with the help of NGOs andthrough the market mechanism where private sector manufacturers are also finding a place. But thisawareness has fallen short of social mobilization and consequently the project targets remainunrealized.
However, some form of publicity for hygiene awareness has been going on, specially under ear l ierphases of SocMob. The SocMob programme of 1997-99 seeks to give a further spurt in this directionin 32 districts of Bangladesh where sanitary activities have fallen short of national average. Hence,deciphering the contribution of SocMob 1997-99 has been rendered difficult. A rigorous evaluation ofthe programme is made all the more difficult due to the absence of a baseline study which is essentialfor a through effect/impact analysis of such a social motivational programme.
6.2 Lesson Learned
In the light of the above conceptual limitations and the experience of the past few years, the fol lowingmay be noted as lessons derived from the Social Mobil izat ion Programme in respect of sanitarylatrines and hygiene awareness.
Accomplishments:
6.2.1 Overall Change in Hygiene Awareness
Changing habits is difficult, but possible. Social mobilization programme has succeeded in improvingthe overall WATSAN situation and creating a measure of hygiene awareness among the people of the32 intervention districts. The focus group discussion and sample survey would allow such aconclusion. The direction of change is evident. Such direction could be better measured with theavailability of a benchmark survey for the programme. With data available from ProgotirPothey, it isevident that sanitary latrine use has increased by 5 per cent between 1997 and 1999 in the interventionareas while national data on the growth or sanitary latrine in urban-rural areas is negative. Data fromthis source wil l not allow one to conclude that 1997-99 SocMob targets have been approached.
6.2.2 Partnership between DPHE/NGO or GOB-NGO
There emerged a fruitful partnership between the government represented by the DPHE, and theNGOs, facilitated by the UNICEF. Besides the DPHE, government officials at the district and upazilalevel, specially the UNO, Health and Family Planning, Education, Information and IslamicFoundation officials got sensitized and motivated to come forward to help the hygiene awarenessprogramme. These officials exuded a sense of appreciation, understanding and social relevance ofSocMob programme. They cooperated with NGOs. Upazila level NGOs were in favour of morecoordination by the UNO, specially in respect of UP chairman.
6.2.3 Sensitization and Coordination at District Level
The sensitization function of the advocacy workshops at the district and upazila level appears to beover.
. This part of the programme has served its purpose. Valuable allies have been found among the seniorlevel officials at the district level, specially among the DC, Civil Surgeon, DistrictEducaiton Officer,Assistant Director, BRDB, District Information Officer and the Deputy Director, Islamic Foundation.
All these officers can help future expansion of Social Mobilization. However, a coordinating orfacilitating agency has to pursue them at the district level.
6.2.4 Emphasis of Coordination at Upazila Level (Coordination Mechanism)
There is a base on which future social mobilization programme for hygiene awareness could befurther streamlined and augmented. There is, albeit, a need for greater coordination of their activitiesat the upazila level. It transpired from discussion with the upazila level NGOs, DPHE staff, otherupazila level officers and union parishad chairman that the good office of the UNO could bemeaningful ly harnessed to offer this coordinating role with fu l l measure of participation of the localNGOs, DHPE and other related government officials and UP chairman. The U.C.C wil l be availablefor co-ordination of SocMob related activities in the future.
A permanent and more sustaining secretarial base or faci l i ta t ing agency at the upazila level isessential for coordination of hygiene awareness activity which could be conveniently offered by theor SAE/ DPHE, with cooperation and assistance from suitably selected NGOs. SAE/ DPHE does nothave enough manpower to do it alone.
6.2.5 Programme for Hygiene Awareness at the Union and Grassroots Levels
The SocMob programme did not reach the grassroots level in a manner that would bring about greaterfu l f i l lmen t of the programme targets. Table 5.22 shows that 75 per cent of the respondents witnessedSocMob activities. This might have created some awareness among them about hygiene, sanitationand safe water. But these people may not have reached what is often termed as "critical awareness".This critical awareness needed to motivate one to adopt a sanitary latrine may be brought about onlybe persistent persuasion and social pressure through dialogue in "Uthan Baithacks" or othergrassroots level forum.
The social pressure by the UP chairman may be seen under Section 4.6.1 where the chairmanmotivated the parents to install pit latrines for their ch i ldren .
Likewise, family pressure further reinforced by pep talk by H&FP workers motivated a householdhead to install a sanitary latrine as may be seen from the following case study:
User Case Study
Muktar Uddin of Village Kodalia-Union-Chandipasha-Upazila-Pakundia-Dist, Kishoregcmj
Muktar Uddin is a trader with 10 members in the family. Two of his sons are also traders. Hishouse is built on 11 decimal of land. They use sanitary latrine with ring and slab, becausesuch environment friendly latrines ensure healthy living and prevent diarrhoea!, diseases.
His decision to adopt a sanitary latrine is revealing. Ladies in the houses requested him toinstall a sanitary latrine on the advice of local health and family planning workers, but he didnot oblige. However, when he heard miking in the area on sanitar}> latrine and gathered moreinformation from local meetings, fairs, folksongs on SocMob, he got sufficiently motivated tohave such latrine almost 2 years back. He was particularly impressed by the information onthe ill effects of unhygienic latrines. He got in contact with BRAC and got a ring slab latrineinstalled at a cost of'Tk. 200. He has seen SocMob in action through miking, school meetings,video film shows, lectures by learned people and through organized folk songs.
He did not see any propagator of SocMob in the house, though womenfolks of the house wereapproached by Health and Family Planning (HFP) workers. He has been helped by BRAC. Itgave him loan in 1996 to start a cloth shop in Kodalia bazar. His family depends on theincome of that shop. BRAC also helped him in 1998 through the supply of the ring slabs at acost of Tk. 200.
\\PCnPCI_BKepart-J\UNlCEF-SocMab\Final Rq>mt\Chaptcr-&iliK
The BRAC priogramme organizer inspected the latrine after its installation. He and his familyuse both ash and soap to wash hands after toilet. Ash and soap are kept separately in thehouse.
His family drinks tubewell water except in April/May when the tubewell dries up. At that timepond water is boiled for drinking.
He acknowledges direct influence by SocMob, particularly its Radio and TV programmes. Heis also aware of other NGOs in the area besides BRAC.
He received a tubewell from the union council at a cost of Tk. 900. People around his housealso use the tubewell.
Floods of 1998 did not affect his latrine as his locality is on a somewhat high land. He offeredthe following suggestions to tackle the water and sanitation problems of the area:
• People of the village should be approached with simpler methods and language;» Motivational teams may go from house to house campaigning for WATS AN
programme;* Poorer sections may be offered latrines without cost or through installment credit.
Where the UP Chairman and members showed active interest, open defecation could be controlledwith pit latrines at minimum cost. Social pressure may be brought to bear on the households whosepossible costs could not be too high or prohibitive. A&VDP members working in close contact withUP Chairman have knowledge of WATSAN activities through training at Ansar Academy.
To sustain and promote interest of the UP Chairmen and members, the upazila coordinationcommittee (WATSAN Committee) with UNO as active chairmen is essential with regularcoordination meetings on a certain day of month.
There are a considerable number of grassroots level government workers (H&FP/A&VDP) andschool teachers/students to work for SocMob.
SocMob programme could enthuse school students, teachers and Imams. However, they needactivities to pursue. District level education officers are required to inform the schools and upazilaeducation officers in this respect.
Miking, postering, leaflets, folksongs, Radio/TV programmes and school meetings are effectivemeans of communication. The scope for elaborate training for workshops appears to have d imin i shed .
Now, sanitary latrine technology should be disseminated among the UP Chairmen/Members and otherrural elites.
6.2.6 Total Literacy Programme (TLM) and Non-Formal Education (NFE)
Primary and Non-Formal Education Division (NFED) has a crash programme to bring about totalliteracy in the country. In the curricula of the TLM, sanitation, hygiene and safe water could beincluded. TLM teaches subjects that are intimately associated with development of life skill. As themethodology of TLM is one of persuasion, SocMob could have partnership with TLM or NFE (Non-Formal Education) projects of the Ministry of Primary and Mass Education.
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6.2.7 NGOs
NGOs have built up a capability to deliver the latrine equipment. SocMob did not suffer due tounavailabil i ty of latrine equipment. NGOs opened sub-centres away from upazila headquarters forlatrine equipment distribution if demand so required.
NGOs Forum and ind iv idua l NGOs are moderately equipped with their monitoring capabilities.However, according to NGO Forum, their monitoring of SocMob could be further enlarged andstrengthened.
NGOs have given a good account of themselves in the functions related to t ra ining and facilitation ofadvocacy workshops and distribution of latrine equipment.
Association of NGOs with SocMob activities at least at the upazi la , un ion and grassroots level w i l l beconducive to better implementation of the programme.
i ^6.2.8 Private Sector
!]] Private sector producers are coming in the manufacturing of latrine equipment.
I More of them w i l l be coming if the present supply pushed marketing yields to demand pul led—j marketing in the future.
6.2.9 Poverty and Use of Sanitary Latrine
1 Most of the non-users would l ike to blame their poverty for non-acceptance of sanitary latrine as maybe seen from the following case study. They wish for heavy subsidies or free distribution.
User Case Study
Md. Habibur Rahman, Vill-Nowdapara, Union-Dasuria, Upazilu-Eswurdi, Dist.-Pabna. Heis a tea shop owner and like all other non-users, blames his poverty for non-acceptance ofsanitary latrine. Radio is the only source of his information for better hygiene or SocMobrelated programme. Any NGO or Health and Family Planning workers did not approach him.However, he is aware of the beneficial effects of sanitary latrines.
However, other stories are also heard. Comparatively well off persons do not install sanitary latrinesdue to ignorance or lack of sufficient motivation or lack of taste.
6.2.10 Pockets of Ignorance
While the beneficial effects of sanitary latrines or safe dr inking water are shared by many even if theywere not formally approached by any organization or ind iv idua l , pockets of ignorance exist onhygiene awareness including hand washing or water sealed latrines. The gooseneck was often not inplace or -was broken. Practice of hand washing with soap after defecation or before meal still neededto be significantly improved. Technicality of the gooseneck has to be further explained. Peoplewanted to know about the quality of the rings and slabs.
6.2.11 Continuity of Instruction on Hygiene Awareness
Dissemination of hygiene awareness is a continuous process. Knowledge and awareness abouthygiene and sanitation wil l have to be expanded continuously through general education. However, atthe present level of poverty, ignorance and mass education in Bangladesh, the need for a continuedprogrammatic approach to hygiene awareness is evident. SocMob has been just doing that. The timefor its termination has not yet come, though programme components and strategies may have to beadopted with changed situation and experiences.
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Obstacles:
6.3 Obstacles to Implementation of SocMob
6.3.1 External Forces
The 1998 floods put a damper on to the enthusiasm created for SocMob programme at the district,upazila and union levels. Officials at those levels who bore the brunt of taking the SocMob forwardgot embroiled in flood relief and subsequent rehabilitation work. The emphasis on SocMob, therefore,suffered. This phenomenon could partly explain why the sensitization process did not percolate to thegrassroots in due measure. Floods also washed away some of the pit latrines.
6.3.2 In-built Issues Needing Improvement
Co-ordinating and Facilitating Agency:
There is a dire need for a central coordinating and facilitating agency, especially at the district,upazila and union levels. A formal coordinating agency could be created within DPHE with clearroles specified for the NGOs. A base appears to have been created where GO-NGO cooperation maybe fruitfully augmented. It will be quite logical to run SocMob activities as a project under DPHEwith assistance form NGOs, specially at the upazila, union or village levels.
Role of UNO and Union Parishad Chairman at Rural Level:
Even if DPHE runs SocMob as a project, the role of the UNO at the upazila level or the UP Chairmanat the un ion level could not be underestimated. Upazila level NGOs felt the need for the leadership ofthe.UNO with a view to mobil izing the Union Parishad Chairmen/ Members.
UP Chairmen/Members not always motivated:
In the process of implementation, SocMob programme did not put enough emphasis on the role andfunctions of the grassroots stakeholders. The UP Chairmen/members were not often motivated.Upazila and union WATSAN Committees were moribund. The reasons are not far to seek; there wereno financial incentives. However, in the local government administrative seu-up, the UNO enjoysconsiderable clout and influence over the Union Parishad Chairmen/Members and thus is in a positionto influence and motivate those.
Monitoring:
Monitoring was not strong enough. In any future project, monitoring and evaluation should be madean integral part of the project set-up. (
Short Time Span:
Time span of SocMob was not commensurate with the tasks. Hygiene awareness being a continuousprocess, the time span might be larger than 1997-99.
.Target Fixation is not explained
The targets of SocMob were not based on any past experience. There was no logical framework usedto convert inputs to outputs to effect/impacts.
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I Behavioral change is a diff icul t process. This concept has to be instilled in the process ofimplementation of the SocMob programme.
]1 These are some of the obstacles to implementation of SocMob programme, which need to be
addressed in the future.
i 6.4 Recommendations and Future Directionsi
The recommendations and suggestions follow from the presentations and analysis offered in the| previous pages along with the recommendations of the studies reported in Chapter-Ill, particularlyi those submitted in connection with HAPIC implementation process.
] The recommendations follow by and large the sequence of presentation in the main chapter on f i n d i n gj (Chapter-IV).
, Recommendations by Tiers Local GovernmentI> The recommendations are made with the assumption that DPHE wi l l run SocMob activities as a
project.
] District Level
j 1. District level advocacy workshops and sensitization may be reduced, new emphasis beingj on district level planning, co-ordination and monitoring:i
2. Executive Engineer (XEN), DPHE will be the head of the facilitating agency at the districtlevel The D.C.C at the district level will be the co-ordinating agency where functions ofseveral district level offices working for SocMob will be co-ordinated. XEN/ DPHE may bein need of assistance from suitably selected NGOs who have experience in motivationalactivities with great outreach and interpersonal skill and persuasion;
\ 3. District level officials have support for hygiene awareness programme but they have to bepursued to come forward with their assistance and manpower. The D.C.C should do this
-, job of pursuing with active proding from XEN/ DPHE.
J 4. Advocacy, motivation and technical knowledge about sanitary latrines now should be takento the union and village level. Hence, district level training may yield to upazila/union level
} training arrangements.I
Upazila Level
! 5. Upazila may be the focus of attention and facilitating agency should be established herej with SAE/DPHE as the contact point. As SAE/ DPHE does not have enough manpower,
assistance from- NGOs may be necessary and fruitful for the same reasons as mentionedi under district level above.
6. Monitoring should be coordinated at the upazila level with various government agenciesworking at .the upazila level The facilitating agency will help in m.onitoring. NGO
} assistance will be necessary. Training for hygiene awareness will preferably be upazila\ based with liaison with Union Parishad.
7. UNO should be invited to exercise his influence on the Union Parishad Chairman andj Members to participate. In hygiene awareness building projects and activities. Co-j ordination at the upazila will be undertaken at the U. C. C.
Union
8. Union Parishad Chairman/Members should be the focus of operation. NGO could assist asa facilitating agency along with volunteering school teachers and youth groups. Thecoordinating apparatus at. the union level should rope in the services of the followinggovernment personnel/offices and others working at the union/village level .inch/dingH&FP workers, village primary school teachers/ students, Imamas of mosques Ansar andVDP, etc.
9. Besides the above, NGO workers, private producers, youth club members, high schoolteachers and students may also be invited to participate in hygiene awareness building.UNO will have to take leadership to motivate the Union Parishad Chairman to participatein SocMob or Hygiene Awareness Building Project.
Village and Household*t>
10. Village Level Motivation: The emphasis at the grassroots level will be on meaningfuldialogue with the villagers on the desirability of having sanitary latrines and hygienicliving. These dialogues could be held in village schools and courtyard meetings.
11. Village Level Hygienes Outfit: The above organizations and personnel listed under theunion level operation should be detailed to go to the villages, specially those who arefrequent, visitors or residents of the relevant village to speak for hygiene andsanitaiton. Tomake hygiene awareness a continuous process in the foreseeable future, a permanentarrangement of the type suggested above may be commissioned. NGOs may work as thefacilitating and monitoring agency in this respect.
General Recommendations
Some general recommendations are offered below. There could be some overlap with local levelrecommendations, but logical development of the recommendations may require this.
12. Continuity: hygiene awareness building should be made a continuous process to motivatenon-users of sanitary latrines and non-acceptors of hand washing and other importanthygienic practices. The focus of attention should be the union, the rural schools, villages andother grassroots level people and institutions including the Imams, Teachers, Ansar/VDPpersonnel and field level Health and Family Planning -workers.
13. a Coordination and Facilitation: There is a need for co-ordination and facilitation of SocMobactivities. If the hygiene awareness building activities are organized through a project, DP HEbecomes the natural hub of such activity. The XEN/ DPHE and SAE/ DPHE become theleaders and contact persons at the district and upazila respectively. They will be thefacilitators of hygiene awareness building activities and D.C.C and U.C.C will co-ordinatethe activities of other government departments or agencies involved in such activities. NGOsmay have to be selected under the auspices of the project to assist the XEN and SAE of DPHEas they have lack of manpower to undertake these activities. Besides, the NGOs have learntabout SocMob in the past, they have a greater outreach upto the grassroots level, and theyhave experience with social mobilization through interpersonal skill and dialogue.
13 .b. Government Officials at the Upazila Level
UNO has to assume a special role and follow-up UP Chairmen and Members to ensure theirmeaiiingful participation in the programme;
• Education offices at the district and upazila level should write letters to the schools askingthem to participate in the programme;
• The Civil Surgeon of the district and Upazila Health Officer should be more involved in theprogramme:
• School teachers, Family Planning, A&VDP personnel should be made involved in the workthrough the auspices ofD. C. C and U. C. C.
14. Training: Training for hygiene awareness may now be UP, village and grassroots oriented.Awareness building through dialogue and persuasion language should be the principal themeof training. Besides awareness building and motivational effects, certain technical issues maynow be emphasized in training. These relate to the structural aspects of the latrines, roofs oflatrine, their maintenance and durability. Durability is associated with the quality of cement,rods and mortar used and flood depth of the place of the latrine installed. PRA showed thatpeople care to know about these aspects. The use of the gooseneck has to be furtherexplained. Information on children's defecation and subsequent washing may also be stressedat the grassroots.
15. Motivations: Motivation shall remain the main instrument of SocMob-related activities.Motivational activity should now be aimed at the grassroots level dialogue for installation ofsanitary latrine at differing costs reflecting differing options for rings and slabs. The goodwork of posters, leaflets, folksong and fairs including radio and television programme shouldcontinue. However, stress may be laid on "Uthan Baithacks" and the like.
16. NGO Loans and VGD Tied up with Sanitary Latrines: It is also recommended that NGO orGrameen Bank loans or VGD assistance of GOB may be tie-up with the installation ofsanitary latrines.
17 Monitoring: Strong monitoring should constitute an integral part of any future programme ofsocial mobilization.
18. Funds for Grassroots Activities: Experience with the last phase of the programme willsupport the view for enhanced provision of funds for grassroots level activities.
19. Benchmark Survey: In future projects of this nature, it will be advisable to have abenchmark survey on knowledge, attitude and practice, so that monitoring and evaluationmay be facilitated. Distinction should be made between awareness and actual practice. Someaverage data should be disaggregated. Hand washing practice may be disaggreaged intohand washing before meal, after defecation and after cleaning the faces of the minor child.Use of tubewell or pond/river water may be disagregated into cooking eand washing utensils.
20. Subsidies: NGOs and govt. officials and public representatives, all of them opined thatpoverty is a limiting factor. However, subsidies are not recommended at this stage of theprogramme.
21. NGO's Role: NGOs are in the filed installing sanitary latrines even without the participationof the DPHE/UNICEF. Their work in the field should be appreciated and the scope of jointDPHE/ NGO monitoring and evaluation may be explored. Association of NGOs with theimplementation of future SocMob type project run by DPHE will be fruitful as NGOs haveexperience in motivational work at the grassroots level. NGOs have a great outreach upto thevillage level and good interpersonal skill in communication and motivation. Besides, DPHElack manpower at district and upazila levels.
22. Specific Role for Schools/Students: School teachers and students showed considerableinterest in the SocMob, but there was not time to harness their interest to SocMobprogramme. Their enthusiasm for the programme may be meaningfully utilized.
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23. Partnership with TLM and NFE: Partnership with Total Literacy Movement (TLM) andNon-Formal Education (NFE) may be considered as both these programmes are motivationalin nature and aim at reaching the grassroots.
24. Research Programme: A research and development programme or environmental impact ofpit latrine may be initiated.
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IPAPPENDICES